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[骶管麻醉对小儿儿茶酚胺分泌的影响]

[Influence of caudal anesthesia on the secretion of catecholamines in children].

作者信息

Dupont D, Velin P, Cabour F, Candito M, Rives E

出版信息

Ann Fr Anesth Reanim. 1987;6(3):156-8. doi: 10.1016/s0750-7658(87)80072-2.

Abstract

Eighty-two children, class ASA I, between four months and 14 years of age, all undergoing elective subumbilical surgery, were randomly assigned to two groups: a control "halothane anesthesia" group (n = 35) and a 0.25% bupivacaine "caudal anaesthesia" group (n = 47). In the control group, there was a significant peroperative increase in heart rate, respiratory rate, systolic blood pressure and plasma adrenaline levels (p less than 0.05). There was no significant difference in the noradrenaline levels. In the "caudal anaesthesia" group, the haemodynamic response was less pronounced, this being concomitant with a decrease in adrenaline and noradrenaline levels (p less than 0.05 and p less than 0.001, respectively). During surgery, there were significant differences between the groups in heart rate, respiratory rate, noradrenaline levels (3 +/- 0,30 nmol X l-1 vs 1.68 +/- 0.18 nmol X l-1; p less than 0.001) and adrenaline levels (1.67 +/- 0,28 nmol X l-1 vs 0.78 +/- 0.08 nmol X l-1; p less than 0.01). It is concluded that the catecholamine response in children undergoing minor abdominal surgery has been blocked by caudal anaesthesia.

摘要

82名年龄在4个月至14岁之间、ASA I级的儿童,均接受择期脐下手术,被随机分为两组:对照组“氟烷麻醉”组(n = 35)和0.25%布比卡因“骶管麻醉”组(n = 47)。对照组术中心率、呼吸频率、收缩压和血浆肾上腺素水平显著升高(p < 0.05)。去甲肾上腺素水平无显著差异。在“骶管麻醉”组,血流动力学反应不那么明显,同时肾上腺素和去甲肾上腺素水平下降(分别为p < 0.05和p < 0.001)。手术期间,两组在心率、呼吸频率、去甲肾上腺素水平(3 ± 0.30 nmol·L⁻¹ 对 1.68 ± 0.18 nmol·L⁻¹;p < 0.001)和肾上腺素水平(1.67 ± 0.28 nmol·L⁻¹ 对 0.78 ± 0.08 nmol·L⁻¹;p < 0.01)方面存在显著差异。得出结论:骶管麻醉已阻断了接受小型腹部手术儿童的儿茶酚胺反应。

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