Effect Of Lappaconitine On The Level Of Stress Hormone Following Surgery In Patients

【Objective】To observe the effect of lapppaconitine on the level of stress hormone in patients following surgery.And to explore the possible mechanisms of the influence of lapppaconitine on stress response following surgery.【Methods】45 patients who suffered from nucleus pulposus of lumbar,lumbar spinal stenosis,lumbar spondylolisthesis were selected to study and divided randomly into 3 groups(n=15):group of Lapppaconitine(group L).The patients were treated with lappaconitine(8mg)intravenously within 30min before total intravenous anaesthesia(TIVA)was conducted,and lappaconitine with a speed of 2ml/h(0.28mg/ml) was infused continuously since anaesthesia was beginning.PCIA(Patient -controlled intravenous analgesia)started as soon as the patients woke up from anaesthesia.The total dose of lappaconitine was 36mg;Group of tramadol(group T).The patients were treated with tramadol(100mg)intravenously within 30min before TIVA was conducted,and tramadol with a speed of 2ml/h(8mg/ml)was infused continuously since anaesthesia was conducted.PCIA started as soon as the patients woke up from anaesthesia.The total dose of tramadol was 900mg;The blank control group(group B).All patients undergone TIVA.And the blank control group did not received either lappaconitine and tramadol during operation or PCIA.The controlled group was treated intramuscularly with pethidine(50mg)and droperidol(2.5mg)each time as needed after operation.Blood samples were collected at the time-point of 30min before anaethesia was conducted,the moment of surgery was over,24h after surgery and 48h after surgery to detect the level of glucose,insulin,cortisol, adrenocorticotrophin,aldosterone andβ-endorphine.【Results】There were no significant difference at the time-point of 30min before anaethesia was conducted in any group(P＞0.05).There were significant difference of glucose and aldosterone at the moment of surgery was over compared with which at the time-point of 30min before anaethesia(P＞0.05)in group L.There were significant difference of glucose,cortisol,adrenocorticotrophin,aldosterone andβ-endorphine at the moment of surgery was over and 24h after surgery in group T compared with that in group L(P＜0.05).There were significant difference of adrenocorticotrophin,aldosterone andβ-endorphine at 48h after surgery in group T compared with that in group L(P＜0.05).There were significant difference of glucose,cortisol,adrenocorticotrophin,aldosterone andβ-endorphine at any time-points compared with that before anaesthesia in group B(P＜0.05 or P＜0.01).There were significant difference of glucose,cortisol,adrenocorticotrophin,aldosterone andβ-endorphine at all time-points after surgery in group B compared with that in group L(P＜0.05或P＜0.01)There were significant difference of glucose,cortisol,adrenocorticotrophin,aldosterone andβ-endorphine at the moment of surgery was over,24h after surgery and 48h after surgery in group B compared with that in groupT(P＜0.05).【Conclusion】Lappaconitine used following surgery can effectedly inhibit the releasing of glucose,cortisol,insulin,adrenocorticotrophin,aldosterone andβ-endorphine in patients' blood.Lappaconitine is able to inhibit the stess response following suegery,which may own to the multiple pharmacal mechanism of lappaconitine.