摘要
33例胆囊切除术患者随机分为三组 ,A组针刺复合小剂量硬膜外麻醉 1 1例 ,B组穴位电极刺激复合小剂量硬膜外麻醉 1 1例 ,C组单纯小剂量硬膜外麻醉 1 1例。每例于术前 1天、术中(麻醉后 3 0min)及术后第三天 ,分别抽静脉血测定血浆去甲肾上腺素 (NE)、肾上腺素 (E)、多巴胺(DA)含量。结果 :A、B两组血浆NE值术中比术前降低 ,其中A组术中比术前降低有显著差异(P <0 .0 1 ) ,C组 (对照组 )NE值术中比术前略升 ;血浆E值A、B两组术中较术前显著升高 (P <0 .0 1 ) ;血浆DA值三组术中与术前比较均上升。术后 3天血浆NE、E、DA值开始恢复或接近术前一日水平。提示针刺 (A组 )或穴位电极 (B组 )在硬膜外复合麻醉中仍具有调整交感神经功能的作用。针麻效果的差异与血浆NE的变化关系较为密切 ,与血浆E、DA变化相关较少 ,血浆NE含量释放减少者 (A、B两组 )针麻效果优良 ,释放多者麻醉效果较差。上述检测结果同样显示针刺 (或穴位电极 )复合硬膜外麻醉可能具有减轻或缓解手术应激反应的作用。
Objective:To observe the effect of peripheral norepinephrine (NE) level on acupuncture analgesia.Methods:33 cases of cholecystectomy patients were randomly divided into group A (acupuncture combined with extradural-T 4～12 administration of small dose of analgesic, lidocaine 1.5%, 4 mL),group B (electrical stimulation of acupoint skin via cutaneous electrodes combined with extradural administration of small dose of analgesic)and group C (control group, only extradural administration of small dose of analgesic). Each group contained 11 cases respectively. The plasma NE,epinephrine(E) and dopamine (DA) concentrations were determined on the day before operation, during operation (30 minutes after anesthesia) and 3 days after operation in all the cases using high pressure liquid chromatography (HPLC)-electrochemical technique.Bilateral Zusanli (ST 36) and Neiguan (PC 6) were used and stimulated electrically with frequency 2/15 Hz, intermittent waves, and 2 ～ 3 mA for group A and 13 mA for group B.Results: The results showed that in group A and B,the plasma NE concentrations reduced respectively from 3.85±1.47 ng/mL and 2.90±1.49 ng/mL of pre operation to 2.28±0.84 ng/mL and 2.34± 1.57 ng/mL during operation. There were significant differences between pre and post operation in NE level in both groups (P<0.01).While in group C,the NE level increased from 2.73±1.26 ng/mL to 2.89±1.46 ng/mL during operation.The contents of plasma E in group A, B and C increased obviously and respectively from 2.33±0.58 ng/mL , 1.74±1.22 ng/mL and 1.85±0.77 ng/mL of pre operation up to 3.67±1.39 ng/mL , 3.19±1.92 ng/mL and 2.51±1.62 ng/mL during operation (P<0.01). The plasma DA contents in the 3 groups also increased during operation.All the values of plasma NE,E and DA on the 3rd day after operation in the 3 groups were close to the basic levels of pre operation.It indicates that either acupuncture or acupoint superficial electrical stimulation combined with extradural anesthesia assum
出处
《针刺研究》
CAS
CSCD
2001年第1期54-57,共4页
Acupuncture Research
基金
"九.五"国家攻关课题资助!(编号 :96 90 6 11 0 1)
关键词
胆囊切除术
针刺麻醉
硬膜外麻醉
儿茶酚胺
Cholecystectomy Acupuncture anesthesia with extradural anesthesia Plasma catecholamine
