Davis F M, Laurenson V G, Lewis J, Wells J E, Gillespie W J
Br J Anaesth. 1987 Jun;59(6):725-9. doi: 10.1093/bja/59.6.725.
Whole blood glucose concentration was estimated in 93 patients undergoing total hip arthroplasty under either subarachnoid or general anaesthesia. In 77, plasma cortisol concentration was also estimated before and after surgery. There were no preoperative differences between the two groups. Blood glucose concentration increased slightly following induction in both groups, but with spinal anaesthesia it decreased again, whereas with general anaesthesia it continued to increase (P less than 0.0001). Plasma cortisol concentration with spinal anaesthesia was 291 (SD 145) nmol litre-1 before, and 279 (253) nmol litre-1 30 min after operation. With general anaesthesia there was a three-fold increase from 301 (159) nmol litre-1 (preoperative) to 987 (474) nmol litre-1 30 min after operation (P less than 0.0001). Low spinal anaesthesia with a predominantly unilateral block appears sufficient to suppress the neuroendocrine response to hip surgery.
对93例接受蛛网膜下腔麻醉或全身麻醉下行全髋关节置换术的患者测定了全血葡萄糖浓度。其中77例患者还在手术前后测定了血浆皮质醇浓度。两组患者术前无差异。两组患者诱导后血糖浓度均略有升高，但蛛网膜下腔麻醉后血糖浓度再次下降，而全身麻醉后血糖浓度持续升高（P＜0.0001）。蛛网膜下腔麻醉患者术前血浆皮质醇浓度为291（标准差145）nmol/L，术后30分钟为279（253）nmol/L。全身麻醉患者术前血浆皮质醇浓度为301（159）nmol/L，术后30分钟升至987（474）nmol/L，增加了三倍（P＜0.0001）。以单侧阻滞为主的低位蛛网膜下腔麻醉似乎足以抑制髋关节手术引起的神经内分泌反应。
