Kataja J, Viinamäki O, Punnonen R, Kaukinen S
Department of Anaesthesia, Tampere University Central Hospital, Finland.
Eur J Anaesthesiol. 1988 Mar;5(2):121-9.
The effects of halothane and isoflurane anaesthesia on plasma renin activity and plasma concentrations of aldosterone and vasopressin were investigated in 20 cholecystectomy patients. Plasma renin activity rose significantly during both halothane and isoflurane anaesthesia without surgery, and increased further after the commencement of operation. Plasma aldosterone increased slightly during halothane and isoflurane anaesthesia, but the highest concentrations, three times the control values, were measured during surgery in both groups. Plasma vasopressin decreased during halothane and isoflurane anaesthesia to half of the control values, but rose significantly during cholecystectomy. During anaesthesia and surgery there were no significant differences in the mean arterial pressures of the groups. The results demonstrate that isoflurane stimulates the renin-angiotensin system to a similar extent as halothane, although it causes hypotension by a different mechanism. The activation of the renin-angiotensin-aldosterone system may be an essential compensatory mechanism, which antagonizes the decrease of blood pressure. Plasma vasopressin probably has no role in regulating blood pressure during anaesthesia.
在20例胆囊切除术患者中，研究了氟烷和异氟烷麻醉对血浆肾素活性、醛固酮和血管升压素血浆浓度的影响。在未进行手术的氟烷和异氟烷麻醉期间，血浆肾素活性显著升高，且在手术开始后进一步增加。在氟烷和异氟烷麻醉期间，血浆醛固酮略有增加，但两组在手术期间均测得最高浓度，为对照值的三倍。在氟烷和异氟烷麻醉期间，血浆血管升压素降至对照值的一半，但在胆囊切除术期间显著升高。在麻醉和手术期间，两组的平均动脉压无显著差异。结果表明，异氟烷对肾素 - 血管紧张素系统的刺激程度与氟烷相似，尽管其通过不同机制导致低血压。肾素 - 血管紧张素 - 醛固酮系统的激活可能是一种重要的代偿机制，可对抗血压下降。血浆血管升压素在麻醉期间可能对血压调节无作用。
