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[氟烷、恩氟烷、异氟烷和氧化亚氮实验麻醉中的血浆皮质醇]

[Plasma cortisol in experimental anesthesia with halothane, enflurane, isoflurane and nitrous oxide].

作者信息

Brandt L, Frieling B, Pokar H

机构信息

Klinik für Anaesthesiologie, Johannes Gutenberg Universität Mainz.

出版信息

Anaesthesist. 1988 Feb;37(2):84-90.

PMID:3364667
Abstract

The influence of anesthesia on plasma cortisol has most often been studied in connection with routine operations. To investigate the specific effects of modern inhalation anesthetics more accurately, we examined the specific effects of four inhalation anesthetics on human plasma cortisol during volunteer studies on the influence of anesthetics on the electroencephalogramm. METHODS. A group of 17 (10 m, 7 f) young healthy volunteers who had not received any premedication and were not intubated were studied after informed consent had been obtained. In the first series of experiments the concentration of halothane, enflurane, isoflurane or N2O was increased to MAC (minimal alveolar concentration) 0.5 for a 15-min steady-state period. Blood samples were taken 5 min prior to induction (I), 35 min after induction, on steady-state MAC 0.5 (II), and 15 (III) and 35 (IV) min after the end of anesthesia. In a second series, with 5 subjects, the concentration of halothane, enflurane or isoflurane was first increased to a steady state of MAC 1.0. After reduction to MAC 0.5 steady-state, anesthesia was supplemented with 53% N2O to give a steady state of MAC 1.0 again. Blood samples were taken 5 min prior to induction (I), after the attainment of steady-state MAC 1.0 (II), 35 min later at MAC 0.5 (III), 40 min later at MAC 1.0 with volatile anesthetic/N2O (IV), and 15 (V) and 35 (VI) min after the end of anesthesia. RESULTS. MAC 0.5 N2O produced a marked rise in mean plasma cortisol, from 64.2 micrograms/l to 164.5 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

麻醉对血浆皮质醇的影响大多是在常规手术的背景下进行研究的。为了更准确地探究现代吸入麻醉剂的具体作用,我们在关于麻醉剂对脑电图影响的志愿者研究中,检测了四种吸入麻醉剂对人体血浆皮质醇的具体作用。方法:选取17名(10名男性,7名女性)未接受任何术前用药且未插管的年轻健康志愿者,在获得知情同意后进行研究。在第一组实验中,将氟烷、恩氟烷、异氟烷或N₂O的浓度在15分钟的稳态期内升至MAC(最低肺泡浓度)0.5。在诱导前5分钟(I)、诱导后35分钟、稳态MAC 0.5时(II)以及麻醉结束后15分钟(III)和35分钟(IV)采集血样。在第二组实验中,选取5名受试者,先将氟烷、恩氟烷或异氟烷的浓度升至MAC 1.0的稳态。降至MAC 0.5稳态后,补充53%的N₂O使MAC再次达到1.0的稳态。在诱导前5分钟(I)、达到稳态MAC 1.0后(II)、35分钟后MAC 0.5时(III)、40分钟后使用挥发性麻醉剂/N₂O达到MAC 1.0时(IV)以及麻醉结束后15分钟(V)和35分钟(VI)采集血样。结果:MAC 0.5的N₂O使平均血浆皮质醇显著升高,从64.2微克/升升至164.5微克/升。(摘要截选至250词)

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