von Bormann B, Boldt J, Sturm G, Kling D, Weidler B, Lohmann E, Hempelmann G
Anaesthesist. 1985 Sep;34(9):429-34.
Stress and pain induced by surgical trauma seem to be attenuated when calcium antagonists have been applied. In order to ascertain the effect of nimodipine, a new strong acting calcium channel blocker on plasma levels of various stress hormones twenty patients undergoing cardiovascular surgery where investigated in two groups. Ten patients received high-dose fentanyl anaesthesia (mean: 2,45 mg fentanyl/patient), whereas another ten patients were treated with 0,1 mg fentanyl/patient in addition to nimodipine 1,0 micrograms/kgbw X min (from onset of anaesthesia until start of extracorporeal circulation). Between the two groups were no significant differences with respect to perioperative course and postoperative demand for analgetics. Plasma levels of ACTH, somatotropin, glucose and free glycerol were markedly elevated in all patients (n = 20) intra- and postoperatively, whereas cortisol and prolactin remained unchanged. The present data suggest an additive analgesic effect of nimodipine during surgery. This phenomenon is possibly due to a blocking effect of calcium channel blockers on nociceptive nerves. The present model assumes that calcium is essential in pain perception and that decreased calcium would result in analgesia.
当应用钙拮抗剂时，手术创伤所诱导的应激和疼痛似乎会减轻。为了确定新型强效钙通道阻滞剂尼莫地平对各种应激激素血浆水平的影响，对20例接受心血管手术的患者进行了两组研究。10例患者接受高剂量芬太尼麻醉（平均：2.45mg芬太尼/患者），而另外10例患者除了接受1.0μg/kgbw×min的尼莫地平治疗（从麻醉开始至体外循环开始）外，还接受了0.1mg芬太尼/患者的治疗。两组患者在围手术期过程和术后镇痛药需求方面无显著差异。所有患者（n = 20）在术中和术后促肾上腺皮质激素、生长激素、葡萄糖和游离甘油的血浆水平均显著升高，而皮质醇和催乳素保持不变。目前的数据表明尼莫地平在手术期间具有相加镇痛作用。这种现象可能是由于钙通道阻滞剂对伤害性神经的阻断作用。目前的模型认为钙在痛觉中至关重要，钙减少会导致镇痛。
