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[丙泊酚作为麻醉诱导剂对麻醉和手术期间垂体-肾上腺皮质功能的影响]

[Effect of propofol as an agent for anesthetic induction on pituitary-adrenocortical function during anesthesia and surgery].

作者信息

Murakawa T, Tsubo T, Kudo T, Kudo M, Matsuki A

机构信息

Department of Anesthesiology, Odate Municipal Hospital.

出版信息

Masui. 1998 Nov;47(11):1350-7.

PMID:9852700
Abstract

Effect of propofol as an agent for anesthetic induction on plasma levels of cortisol, beta-endorphin-like immunoreactivity (beta-ELI), growth hormone (GH) and prolactin were evaluated in 20 non-abdominal surgical patients ranged in ages from 19 to 64 years. Anesthesia was induced with either intravenous propofol 2-2.5 mg in ten patients or intravenous thiopental 4-5 mg in the remaining 10 patients as the control group, and succinylcholine was administered intravenously to facilitate tracheal intubation. Enflurane-nitrous oxide-oxygen was then given to maintain anesthesia in all the patients of both groups. Plasma cortisol levels decreased slightly with anesthesia in the propofol group, but they increased slightly after anesthetic induction in the control group. Therefore they were significantly lower in the propofol group than those in the control group. They tended to increase gradually during surgery and reached the peak value after the emergence from anesthesia in both groups. Plasma beta-ELI levels were unchanged with anesthesia alone in the patients of both groups. They tended to increase gradually during surgery and reached the peak value after the emergence from anesthesia in both groups. Plasma GH levels were not affected with anesthesia, but they increased slightly during surgery in both groups. Plasma prolactin levels increased significantly during anesthesia and surgery in both groups, and they decreased after the emergence from anesthesia but were still significantly higher than the preanesthetic values in both groups. The authors' findings suggest that effects of propofol as an agent for anesthetic induction on pituitary-adrenocortical function during anesthesia and surgery are comparable to those of thiopental, and that propofol does not exert inhibitory effect on pituitary-adrenocortical function during anesthesia and surgery.

摘要

在20例年龄为19至64岁的非腹部手术患者中,评估了异丙酚作为麻醉诱导剂对血浆皮质醇、β - 内啡肽样免疫反应性(β - ELI)、生长激素(GH)和催乳素水平的影响。10例患者静脉注射2 - 2.5mg异丙酚诱导麻醉,其余10例患者静脉注射4 - 5mg硫喷妥钠作为对照组,静脉注射琥珀酰胆碱以利于气管插管。然后两组所有患者均给予恩氟烷 - 氧化亚氮 - 氧气维持麻醉。异丙酚组麻醉时血浆皮质醇水平略有下降,但对照组麻醉诱导后略有升高。因此,异丙酚组的皮质醇水平显著低于对照组。两组在手术过程中皮质醇水平均逐渐升高,麻醉苏醒后达到峰值。两组患者单纯麻醉时血浆β - ELI水平均无变化。两组在手术过程中β - ELI水平均逐渐升高,麻醉苏醒后达到峰值。血浆GH水平不受麻醉影响,但两组在手术过程中均略有升高。两组在麻醉和手术过程中血浆催乳素水平均显著升高,麻醉苏醒后下降,但仍显著高于麻醉前水平。作者的研究结果表明,异丙酚作为麻醉诱导剂在麻醉和手术期间对垂体 - 肾上腺皮质功能的影响与硫喷妥钠相当,且异丙酚在麻醉和手术期间对垂体 - 肾上腺皮质功能无抑制作用。

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