Effects Of Different Anesthetic Procedure On TXB₂ And ET In Plasma And Hemodynamics During Upper Abdominal Surgery

Operation,anesthesia and mental elements can lead to stress response.Harmful stress or distress can cause serious illness . Stress is associated with neuroendocrinology.So the level of hormone and its biology effect, and the choise of anesthesia method in stage of surgery is our important question for study in order to protect patients. At present, there are many research on stress. For example, stress and immune, neuroendocrinology cardiovascular and diges-tion. But most of them are at the beginning. With the development of science, we may have advanced studies. Stress is a kind of neuroendocrinology actions when the body is strongly shocked. The sympathetic-adrenal medulla axis and hypothalamus-pitutary-adrenal cortex system(HPA) are the main organs of stress. Stress is essential to our body. It is the important part of protection of the body. But excessive sympathetic-adrenal medulla can wear out lots of energy. So it is necessary to provide good condition and choose reasonable anesthesia method in stage of surgery. Objective To investigate and evaluate the effects of different anesthesia methods on plasma TXB2,ET and hemodynamic during upper abdominal operation so that we can find out the relationship among stress,endocrinology and anesthesia. Methods Twenty ASA â… -â…¡patients aged 32-61yr ; weighted 52-74kg undergoing upper abdominal operation were randomly divided into two groups. There are no significant differences in general condition between two groups. Group â… : intravenous-inhalation anesthesia + epidural block(n=10). Group â…¡: intravenous-inhalation anesthesia(n=10). â… group received continuous epidural block(T8-9) before intravenous-inhalation anesthesia; We choose T8-9 as epidural block point.â…¡group received the same anesthesia except epidural block. Anesthesia was induced with midazolam 0.1mg.kg-1; Fentanyl 2-4ug.kg-1 vecuronium0.07~0.15mg.kg-1.propofol 1~1.5mg.kg-1.The patients were mechanically ventilated after tracheal intubation ( FiO2=100%,RR=12~14bpm,Vt=8~12ml.kg-1, PETCO2=35~ 45mmHg) and maintained with 1-3% Isoflurance inhalation and intermitlent iv boluses of vecuronium and propofol by TCI. â… group was combined with epidural anesthesia(T8-9). ECG,SpO2, PETCO2 ,SBP,DBP,HR were continuously monitored during operation.6ml blood sample was take before induction of anesthesia,2min after induction,2min after skin incision,exploring during optation,2min after extubation for determination of plasma TXB2,ET concentration.And recorded SBP,DBP,HR at the relatedtime point. Results 1. TXB2 â‘ In group II plasma TXB2 concentration was significantly increased from 2min after kin incision to 2min after extubation during operation as compared with the baseline values(before induction of anesthesia),and was significantly higher in group II than that in group â… at the same time point(P<0.05 or 0.01). â‘¡In group I plasma TXB2 concentration was not significantly increased during operation(P>0.05),except that plasma TXB2 was significantly higher at 2min after extubation than the baseline values(P<0.05). 2. ET: In groupâ… ,â…¡,plasma ET concentration was not significantly increased during operation(P > 0.05) except that plasma ET was significantly lower at 2min after extubation than the baseline values(P<0.05), and were not significantly higher in group â…¡than that in group â… during operation(P>0.05). 3. SBP and DBP:â‘ In groupâ… ,â…¡,SBP and DBP were not significantly changed during operation(P>0.05)except that SBP and DBP were significantly lower at 2min after extubation than the baseline values (P<0.05 or 0.01). â‘¡In group â… ,SBP was significantly lower than that in group â…¡at 2min after induction (P<0.05). â‘¢In group â… ,DBP was significantly lower than that...