von Bormann B, Weidler B, Dennhardt R, Frings N, Hempelmann G
Reg Anaesth. 1982 Jan;5(1):7-10.
10 patients scheduled for thoracic, abdominal or vascular surgery received anaesthesia as a combination of neuroleptanalgesia plus epidural opiate-analgesia. Antidiuretic hormone levels (ADH), serum-electrolytes (Na+, K+) and plasma osmolality have been investigated preoperatively (twice), intraoperatively (six times), during the first postoperative day (three times) and for five days postoperatively (once a day). There was a significant increase in ADH in all patients intra- and postoperatively, whereas serum-electrolytes and plasma-osmolality stayed within normal range. Maximum ADH-values were measured during the intraoperative period, postoperatively ADH-levels reached the normal range after 5 days. This increase in plasma-ADH-levels was not accompanied by typical haemodynamic changes. From the aspect of metabolic endocrine response to surgery, our results indicate no advantage of the combination of neurolept-analgesia plus epidural opiate-analgesia for the intraoperative period.
10例计划进行胸科、腹部或血管手术的患者接受了神经安定镇痛加硬膜外阿片类镇痛的联合麻醉。术前（两次）、术中（六次）、术后第一天（三次）以及术后五天（每天一次）对患者的抗利尿激素水平（ADH）、血清电解质（Na +、K +）和血浆渗透压进行了检测。所有患者在术中和术后ADH均显著升高，而血清电解质和血浆渗透压保持在正常范围内。术中测得ADH的最大值，术后5天ADH水平恢复正常范围。血浆ADH水平的升高并未伴随典型的血流动力学变化。从手术的代谢内分泌反应方面来看，我们的结果表明神经安定镇痛加硬膜外阿片类镇痛联合麻醉在术中并无优势。
