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[神经安定镇痛术对手术所致抗利尿激素升高的影响]

[Effect of neuroleptanalgesia on operation-induced rise in the antidiuretic hormone].

作者信息

Weidler B, von Bormann B, Dennhardt R, Lennartz H, Hempelmann G

出版信息

Anaesthesist. 1983 May;32(5):226-8.

PMID:6869765
Abstract

Plasma-levels of antidiuretic hormone were measured in patients undergoing major abdominal surgery pre-, intra- and postoperatively. All patients (n=20) received neuroleptanalgesia as anaesthetic procedure; 10 of them received etomidate additionally. Initial value of vasopressin as well as values after induction of anaesthesia stayed within normal range in all patients. The operation period was accompanied by elevated ADH-levels with a maximum of 500% above initial values. 5 patients having been antagonized postoperatively with naloxone 0.005 mg/kgbw showed marked increase in ADH-level. In comparison to former investigations we conclude that NLA can not block stress-induced rise in vasopressin-concentration effectively as seen under the combination of NLA plus epidural analgesia.

摘要

对接受腹部大手术的患者在术前、术中和术后测量抗利尿激素的血浆水平。所有患者(n = 20)均接受神经安定镇痛作为麻醉方法;其中10例还额外接受了依托咪酯。所有患者的血管加压素初始值以及麻醉诱导后的数值均保持在正常范围内。手术期间抗利尿激素水平升高,最高比初始值高出500%。5例术后用0.005 mg/kg体重的纳洛酮拮抗的患者,其抗利尿激素水平显著升高。与之前的研究相比,我们得出结论,与神经安定镇痛加硬膜外镇痛联合使用的情况相比,神经安定镇痛不能有效阻断应激诱导的血管加压素浓度升高。

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