Håkanson E, Rutberg H, Jorfeldt L, Mårtensson J
Br J Anaesth. 1985 Apr;57(4):394-9. doi: 10.1093/bja/57.4.394.
The influence of thoracic extradural local anaesthetics (0.5% bupivacaine) or extradural morphine on the metabolic response to upper abdominal surgery was compared with the administration of morphine i.v. in the period after operation. The extradural local anaesthetic group had significantly lower blood glucose and plasma FFA concentrations and consistently, but not significantly, lower blood glycerol and lactate concentrations than both the other groups. At 4 h both extradural groups had significantly lower plasma FFA and blood 3-hydroxybutyrate concentrations than the control group. Blood alanine concentration decreased in all three groups with a minimum at 24 h. There were no differences in serum insulin concentrations between the groups. It is concluded that thoracic extradural morphine differs from thoracic extradural local anaesthetics in being much less able to suppress the metabolic response associated with upper abdominal surgery.
在术后期间，将胸段硬膜外局部麻醉药（0.5%布比卡因）或硬膜外吗啡对腹部手术代谢反应的影响与静脉注射吗啡进行了比较。硬膜外局部麻醉药组的血糖和血浆游离脂肪酸（FFA）浓度显著低于其他两组，血甘油和乳酸浓度持续低于其他两组，但差异不显著。术后4小时，两个硬膜外组的血浆FFA和血3-羟基丁酸浓度均显著低于对照组。三组血丙氨酸浓度均下降，在24小时时降至最低。各组间血清胰岛素浓度无差异。结论是，胸段硬膜外吗啡与胸段硬膜外局部麻醉药不同，其抑制上腹部手术相关代谢反应的能力要弱得多。
