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[人体在安氟醚麻醉和神经安定镇痛麻醉期间生长激素和催乳素的变化]

[Behavior of GH and prolactin during enflurane anesthesia and neuroleptoanesthesia in man].

作者信息

Altomonte L, Zoli A, Palumbo P, Greco A V, Schiavello R, Monaco C, Marana E

出版信息

Minerva Med. 1985 Nov 10;76(43):2071-4.

PMID:4069417
Abstract

The present study was designed to investigate the effects of neuraleptanesthesia (NLA) and enflurane (Ethane) anesthesia on plasma levels of growth hormone (GH) and prolactin (PRL) in man. A total of 18 patients aged between 20 and 65 years scheduled for elective open-heart surgery were divided in two groups. In the first group (9 patients) general anaesthesia was induced with sodium thiopental (TPS) (3-5 mg/kg) and was maintained with enflurane administered with an inspired concentration of 1.5% in nitrous oxide (2 litres/min) and oxygen (2 litres/min). In the second group (9 patients) anaesthesia was induced with dihydrobenzopyridol (BPS) (0.1-0.2 mg/kg), fentanyl (5-8 gamma/kg) and TPS (3-5 mg/kg) and was maintained with fentanyl (0,65 mg in average). The patients had neither hepatic, renal or endocrine disease nor did they have a history of steroid therapy. All subjects received atropine (0.01 mg/kg) and diazepam (0.2 mg/kg) i.m. 2 hours before induction of anaesthesia. Blood samples for GH and PRL was collected before induction of anaesthesia (0) and at 30, 60, 90 and 120 minutes after induction: the 90' sample was taken immediately after sternal incision. The sampling was stopped at the start of the cardiopulmonary by-pass. A significative reduction of GH at 60' and of PRL at 30' was observed in both groups. Surgical stress at 90' does not evoke a significant increase of PRL and GH levels in both groups. In conclusion NLA and enflurane induced a decrease of GH and PRL plasma levels; in both groups the anaesthetic agents, at the dosage used during anaesthesia, blocked the response of these hormones to the surgical stress likely due to a block of the hypothalamic-pituitary response.

摘要

本研究旨在探讨神经安定麻醉(NLA)和恩氟烷(乙烷)麻醉对人体血浆生长激素(GH)和催乳素(PRL)水平的影响。共有18例年龄在20至65岁之间计划进行择期心脏直视手术的患者被分为两组。第一组(9例患者)采用硫喷妥钠(TPS)(3 - 5mg/kg)诱导全身麻醉,并用恩氟烷维持麻醉,恩氟烷在氧化亚氮(2升/分钟)和氧气(2升/分钟)中吸入浓度为1.5%。第二组(9例患者)用二氢苯并吡啶醇(BPS)(0.1 - 0.2mg/kg)、芬太尼(5 - 8微克/千克)和TPS(3 - 5mg/kg)诱导麻醉,并用芬太尼(平均0.65mg)维持麻醉。患者既没有肝脏、肾脏或内分泌疾病,也没有类固醇治疗史。所有受试者在麻醉诱导前2小时肌肉注射阿托品(0.01mg/kg)和地西泮(0.2mg/kg)。在麻醉诱导前(0)以及诱导后30、60、90和120分钟采集用于检测GH和PRL的血样:90分钟时的样本在胸骨切开后立即采集。在心肺转流开始时停止采样。两组均观察到60分钟时GH显著降低,30分钟时PRL显著降低。90分钟时的手术应激在两组中均未引起PRL和GH水平的显著升高。总之,NLA和恩氟烷可导致GH和PRL血浆水平降低;在两组中,麻醉期间使用的麻醉剂剂量阻断了这些激素对手术应激的反应,这可能是由于下丘脑 - 垂体反应受阻所致。

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