Sigurdsson G H, Lindahl S G, Nordén N E
Acta Anaesthesiol Scand. 1984 Feb;28(1):47-51. doi: 10.1111/j.1399-6576.1984.tb02009.x.
In 28 children undergoing adenoidectomy, plasma concentrations of catecholamines, ACTH and cortisol were measured. Fourteen children were anaesthetized with halothane (seven non-intubated, seven intubated) and 14 with enflurane (seven non-intubated, seven intubated). During undisturbed anaesthesia, plasma catecholamines were significantly higher with halothane than with enflurane (P less than 0.05). Immediately after surgery, catecholamines were increased up to 300% in the halothane groups. In the enflurane groups, however, the catecholamine concentrations remained unchanged. This difference between the two agents, after surgery, was statistically significant (P less than 0.01 for intubated and P less than 0.001 for non-intubated children). Fifteen minutes postoperatively no difference was found in plasma concentrations between the groups. In all four groups, plasma concentrations of ACTH and cortisol increased similarly during the procedure. It was concluded that plasma catecholamines were higher during halothane than during enflurane anaesthesia in children undergoing adenoidectomy. This difference may be caused by a stimulating effect of halothane on the endogenous catecholamine release. This increased sympathomimetic response during halothane anaesthesia was correlated to the incidence of ventricular arrhythmias previously found with this agent during adenoidectomy.
对28例接受腺样体切除术的儿童，测定了其血浆儿茶酚胺、促肾上腺皮质激素（ACTH）和皮质醇的浓度。14例儿童用氟烷麻醉（7例非插管，7例插管），14例用恩氟烷麻醉（7例非插管，7例插管）。在平稳麻醉期间，氟烷麻醉组的血浆儿茶酚胺水平显著高于恩氟烷麻醉组（P<0.05）。手术后即刻，氟烷麻醉组儿茶酚胺升高达300%。然而，恩氟烷麻醉组儿茶酚胺浓度保持不变。两组药物在术后的这种差异具有统计学意义（插管儿童P<0.01，非插管儿童P<0.001）。术后15分钟，两组间血浆浓度未发现差异。在所有四组中，手术过程中ACTH和皮质醇的血浆浓度升高情况相似。得出的结论是，在接受腺样体切除术的儿童中，氟烷麻醉期间的血浆儿茶酚胺水平高于恩氟烷麻醉期间。这种差异可能是由氟烷对内源性儿茶酚胺释放的刺激作用引起的。氟烷麻醉期间这种拟交感神经反应增强与先前在腺样体切除术中使用该药物时发现的室性心律失常发生率相关。
