Kim C
Department of Anesthesiology, Nippon Medical School, Tokyo.
Masui. 1996 Feb;45(2):215-22.
To evaluate the influence of anesthesia on postoperative nitrogen balance after upper abdominal surgery, twenty-seven patients undergoing the surgery were investigated. They were allocated randomly to three groups receiving different anesthetic methods, i.e., epidural anesthesia, general anesthesia or balanced anesthesia. In the epidural anesthesia group, anesthesia was maintained with 0.5% isoflurane, nitrous oxide and oxygen supplemented with epidural analgesia extending from Th 1 to L 3. In general anesthesia group, anesthesia was maintained with isoflurane, nitrous oxide and oxygen. In balanced anesthesia group, anesthesia was maintained with 0.5% isoflurane, nitrous oxide, oxygen and intravenous fentanyl. Epidural fentanyl was used for postoperative analgesia in all groups. There was no significant difference in the cumulative nitrogen balance for three days among the three groups. Postoperative values of IL-6 and CRP also did not differ significantly among the three groups. Postoperative WBC was significantly higher in the balanced anesthesia group than in other two groups. The results suggest that the difference in anesthetic methods does not influence postoperative nitrogen balance.
为评估麻醉对上腹部手术后氮平衡的影响，对27例接受该手术的患者进行了研究。他们被随机分为三组，接受不同的麻醉方法，即硬膜外麻醉、全身麻醉或平衡麻醉。在硬膜外麻醉组，用0.5%异氟醚、氧化亚氮和氧气维持麻醉，并辅以从胸1至腰3的硬膜外镇痛。在全身麻醉组，用异氟醚、氧化亚氮和氧气维持麻醉。在平衡麻醉组，用0.5%异氟醚、氧化亚氮、氧气和静脉注射芬太尼维持麻醉。所有组均使用硬膜外芬太尼进行术后镇痛。三组间三天的累积氮平衡无显著差异。三组间白细胞介素-6和C反应蛋白的术后值也无显著差异。平衡麻醉组的术后白细胞计数显著高于其他两组。结果表明，麻醉方法的差异不影响术后氮平衡。
