Does general anesthesia really control a stress into the operation? -From observation by two autonomic nerves monitors-

自主神经系统(ANS)的稳定性是需要全身麻醉的因素之一。一方面，有一系列的流程被称为预用药、麻醉引入(插管)、麻醉维持、肌肉松弛逆转(苏醒和拔管)。每一阶段用药对患者的稳定有多大的贡献，或用ANS监测仪进行评估。1.用药前用药的影响咪达唑仑或羟丙嗪不能控制鼻腔治疗的刺激。2.麻醉导入药物和麻醉维持药物的影响本次使用的所有麻醉导入药物均观察ANS的控制情况。吸入麻醉药七氟烷、异氟醚和静脉麻醉药异丙酚的麻醉效果显著，硫喷妥钠效果较弱。麻醉导入药不能抑制插管对交感神经系统的刺激作用。而芬太尼在麻醉诱导时刺激副交感神经系统(PSNP)，则呈现维持全身ANS平衡的趋势，麻醉诱导时芬太尼是有用的。七氟醚和异氟醚在手术中对ANS有足够的控制作用，且控制程度与浓度呈正相关。在一氧化二氮存在下，0.66MAC的镇痛作用增强了ANS的稳定性。3.硫酸阿托品逆转给药后，高频成分持续降低(PSNP)，低频成分/高频成分短暂升高(ANS平衡)。所有患者均接受依得洛芬和新斯的明减少心率的治疗。新斯的明早期就出现了依地芬胺。

The stability of autonomic nervous system(ANS) is in one of the elements which need general anesthesia. On the one hand, there are a series of flows called premedication, anesthesia introduction (intubation), anesthesia maintenance, muscle relaxation reverse (awakening and extubation). The medicine used for every stage of the had contributed to the stabilization of a patients ANS how much, or it evaluated using of the ANS monitor.1.Influence of premedicationMidazolam or hidoroxyzine of premedication could not control the stimulus of nasal treatment. Thereafter nasal treatment should do after anesthesia introduction.2.Influence of introduction medicine and anesthesia maintenance medicineControl of ANS was observed with all anesthesia introduction medicines used this time. With sevoflurane and isofluran of volatile anesthetic drug and propofol of intravenous anesthetic, it was remarkable and with thiopental it is the weak tendency. The anesthesia introduction medicine could not hold down the stimulus to the sympathetic nervous system(SNS) by the intubation. But, with fentanyl when introducing is used, stimulating parasympathetic nerve system (PSNP), it showed the tendency where ANS balance of the whole is maintained, fentanyl at the time of anesthesia introduction was useful. Sevoflurane and isofluran have the control effect of sufficient ANS during the operation and the degree was relying on density. With nitrous oxide the analgesic action of 0.66MAC has contributed to the stability of ANS. In addition, the additive effect in MAC of the volatile narcotic was able to observed.3.ReverseBy atoropine sulfate medication, continuation of reduction of high frequency component (PSNP) and a transient rise of a low frequency component/high frequency component (balance of ANS) were accepted. Reduction in cardiac beats rate was accepted with all cases by edrophonium and neostigmine. And the edrophonium appeared at an early stage from neostigmine.