• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >The effects of combined epidural and general anesthesia on the autonomic nervous system and bioavailability of nitric oxide in patients undergoing laparoscopic pelvic surgery.
【24h】

The effects of combined epidural and general anesthesia on the autonomic nervous system and bioavailability of nitric oxide in patients undergoing laparoscopic pelvic surgery.

机译：硬膜外麻醉和全身麻醉联合对腹腔镜盆腔手术患者的自主神经系统和一氧化氮的生物利用度的影响。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Pneumoperitoneum during laparoscopic surgery is known to affect visceral blood flow and result in oxidative stress. Whether epidural anesthesia will effectively reduce visceral ischemia and oxidative stress by blocking the sympathetic nervous system (SNS) during laparoscopic surgery has not been proven.Forty-five patients who were to undergo robot-assisted laparoscopic prostatectomy were randomly assigned to the combined general-epidural anesthesia group (group GE, n = 22) or to the general anesthesia group (group G, n = 23). Blood pressure, heart rate, and the balance between sympathetic and parasympathetic nervous system activity as measured by heart rate variability were recorded at 10 min after induction of anesthesia (T1), 60 (T2) and 120 (T3) min after intra-abdominal CO(2) insufflation, and 10 min after returning the patient to the supine position following CO(2) exsufflation (T4). Arterial blood gas analysis and blood sampling for measurements of nitrite (NO(2-)) and malondialdehyde (MDA) were performed at all time points.Intraoperative mean blood pressure was significantly lower in group GE compared with group G. The low-frequency to high-frequency ratio was significantly increased after induction of pneumoperitoneum in group G but was unchanged in group GE. Plasma levels of nitrite decreased after pneumoperitoneum induction in group G while there was no change in group GE. A significant increase in MDA levels was seen in group G after pneumoperitoneum induction and were higher than group GE at T3 and T4. The 24-h urine output was higher in group GE than in group G on POD 1. The 24-h CrCl was higher in group GE on POD 1 but was not different between groups on POD 2.Combined epidural and general anesthesia effectively blocks SNS stimulation during laparoscopic surgery and reduces NO inactivation and oxidative stress.
机译：众所周知，腹腔镜手术中的气腹会影响内脏血流并导致氧化应激。硬膜外麻醉能否通过阻断腹腔镜手术过程中的交感神经系统（SNS）来有效减轻内脏缺血和氧化应激尚未得到证实。将接受机器人辅助腹腔镜前列腺切除术的45例患者随机分配至全硬膜外麻醉麻醉组（GE组，n = 22）或全身麻醉组（G组，n = 23）。在麻醉后（T1），腹腔内麻醉（CO）后10分钟（T1），60（T2）和120（T3）分钟记录血压，心率以及通过心率变异性测量的交感神经和副交感神经系统活动之间的平衡（2）吹气，以及在CO（2）吹气（T4）后使患者回到仰卧位10分钟。在所有时间点进行动脉血气分析和血液采样以测量亚硝酸盐（NO（2-））和丙二醛（MDA）。GE组的术中平均血压明显低于G组。 G组气腹后高频比明显增加，而GE组则没有变化。 G组气腹后血浆亚硝酸盐水平降低，而GE组无变化。气腹后G组的MDA水平显着升高，在T3和T4时高于GE组。 GE组的24小时尿量高于POD 1组的G组。POD1组GE组的24h CrCl较高，但POD 2组之间无差异。硬膜外和全身麻醉相结合有效地阻断了SNS刺激腹腔镜手术，减少NO失活和氧化应激。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号