犬硬膜外阻滞对腹部手术应激的初步研究

8例犬间隔1个月分别施行2次腹部手术,第1次采用硬膜外阻滞(试验组,n=8),第2次采用硫喷妥钠静脉麻醉(对照组,n=8)。分别于麻醉前(T0)、麻醉后(T1)、切开腹壁时(T2)、手术30min(T3)、手术完毕时(T4)、手术后24h(T5)、手术后48h(T6)7个时间静脉采血,采用放射免疫法测定血浆皮质醇、白细胞介素-2浓度,采用比色法测定血糖浓度。结果:(1)对照组血浆皮质醇浓度平均值显著高于试验组(P<0·05),尤其在T3、T4时显著高于试验组(P<0·05)。对照组在T3、T4时血浆皮质醇浓度显著高于T0(P<0·05),而试验组各时间与T0比较均无显著差异(P>0·05);(2)对照组血浆白细胞介素-2浓度平均值极显著低于试验组(P<0·01),尤其在T1、T2、T5和T6时显著低于试验组。对照组在T5时、试验组在T3、T4时其血浆白细胞介素-2浓度均显著低于T0;(3)对照组血糖浓度平均值显著高于试验组,尤其在T4时显著高于试验组。对照组在T3、T4、T5和T6时、试验组则在T4时其血糖浓度均显著高于T0。结论:硬膜外阻滞组与硫喷妥钠静脉麻醉比较,硬膜外阻滞能够更有效缓解犬腹部手术的应激反应。

A preliminary study on surgery stress of abdominal operations under epidural block in dogs

Twice abdomial operations of 8 dogs were done at an interval of a month. The first celiotomies were performed with epidual block (experiment group, n1=8), and the second performed with pentothal sodium intravenous anesthesia (control group, n2=8). Blood samples were taken at pre-anesthesia (T0), post-anesthesia (T1), immediately after opening abdomen (T2), 30min post the operation (T3), at the end of operation (T4), 24h (T5) and 48h (T6) after the operation the respectively. The average level of plasma cortisol, interlerkin-2 and blood sugar were measured by radioimmunoassay and colorimetric assay, respectively. The results showed that (1) The average level of plasma cortisol in control group was significantly higher than that in experiment group (P<0.05). Compared with T0, there was significant difference between T3 and T4 in the control group and no significant difference among the other different times in the experiment group (P>0.05); (2) The average level of plasma interlerkin-2 in the control group was significantly lower than that in experiment group (P<0.01), especially at the time of T2, T3, T5 and T6. The levels at time T5 in the control group and T3 and T4 in the experiment group were significantly higher than that at T0; (3) The average level of blood sugar in the control group was significantly higher than that in the experiment group, especially at time T4 in the control group; The level of sugar at T1, T2, T5 and T6 in the control group and at T4 in the experiment group were significantly higher than that at T0. In conclusion, the stress response to abdominal operations in dogs could be relieved more effectively by epidural block than by pentothal sodium intravenous anesthesia.