术中静脉大剂量拉贝他洛尔对血糖的影响。

P C Chung, D C Sum
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引用次数: 0

摘要

由于静脉注射大剂量拉贝他洛尔常用于有意降压麻醉,且有报道称小剂量静脉注射拉贝他洛尔可降低手术应激下的高血糖反应,因此理论上,静脉注射大剂量拉贝他洛尔可能导致更明显的血糖降低。选择行根治性全子宫切除术的女性宫颈癌患者14例(ASA身体状态I-II),随机分为两组(A组和B组),麻醉方式为2.5%硫贲妥钠4 mg/kg、阿托品0.3 mg、丁胆碱1.5 mg/kg、芬太尼3微克/kg。在人工控制通气下,用异氟烷、氧化亚氮、氧气和维库溴铵维持麻醉。桡动脉插管进行连续血压监测和采血。A组于插管后切开皮肤前取第一次血样,B组于切开皮肤后5分钟取第二次血样,给予总剂量拉贝他洛尔后每30分钟取一次血样。A组患者不给予拉贝他洛尔。B组静脉给予拉贝他洛尔(1.0 ~ 1.5 mg/Kg),重复给药(10 mg/Kg),达到皮肤切口后平均血压在60 torr左右。术中给予的液体均不含葡萄糖。所有失血量大于1000ml或在第5个样本(S5)之前输血的患者都被排除在外,因为储存的血液富含葡萄糖。结果显示,两组患者血浆葡萄糖均显著升高,但b组升高较晚。
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The effect of high dose intravenous labetalol on plasma glucose during surgery.

As high dose intravenous labetalol was always used in performing deliberate hypotensive anesthesia and it was reported that small dose of intravenous labetalol would decrease the hyperglycemic response under surgical stress, high dose intravenous labetalol may theoretically causes more pronounced reduction in plasma glucose. 14 female cervical cancer patients (ASA physical status I-II) undergoing radical total hysterectomy were selected and randomly assigned into two groups (group A and group B). The anesthesia was induced with 2.5% sodium thiopental 4 mg/kg, atropine 0.3 mg, succinylcholine 1.5 mg/kg and fentanyl 3 micrograms/kg intravenously. The anesthesia was maintained with isoflurane, nitrous oxide, oxygen and vecuronium under artificial controlled ventilation. Radial artery was cannulated for continuous blood pressure monitoring and blood sampling. The first sample was taken after intubation and before skin incision and the second sample was taken 5 minutes after skin incision in group A and after giving total dose of labetalol in group B, other blood samples were taken every 30 minutes thereafter. No labetalol was given in group A patients. In group B, labetalol (1.0-1.5 mg/Kg) was administrated intravenously in repeated bolus (10 mg/bolus) to achieve a mean blood pressure around 60 torr after skin incision. All the fluid administered intraoperatively was free of glucose. Any patients with blood loss greater than 1000 ml or having blood transfusion before the 5th samples (S5) were excluded because stored blood was rich of glucose. The result revealed that plasma glucose rose significantly in both groups but the rise occurred later in group B.(ABSTRACT TRUNCATED AT 250 WORDS)

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Prolonged fasting in pediatric outpatients does not cause hypoglycemia. Continuous succinylcholine infusion and phase II block in short surgical procedures. [Pheochromocytoma]. [Anesthetic management of intraoperatively diagnosed pheochromocytoma--a case report]. [Postoperative hypoglycemia after pheochromocytoma resection].
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