DOES HALOTHANE ANESTHESIA DECREASE THE METABOLIC AND ENDOCRINE STRESS RESPONSES OF NEWBORN-INFANTS UNDERGOING OPERATION
DOES HALOTHANE ANESTHESIA DECREASE THE METABOLIC AND ENDOCRINE STRESS RESPONSES OF NEWBORN-INFANTS UNDERGOING OPERATION
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DOI：
10.1136/bmj.296.6623.668
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发表时间：
1988-03-05
影响因子：
105.7
通讯作者：
AYNSLEYGREEN, A
中科院分区：
文献类型：
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作者：
ANAND, KJS;SIPPELL, WG;AYNSLEYGREEN, A
由于担心各种麻醉剂在新生儿中的副作用，导致广泛使用未添加一氧化二氮和氧气的麻醉，肌肉松弛药就是这样的患者。为探讨该方案的效果，将36例围术期新生儿随机分为两组：一组仅用氧化亚氮和氯仿麻醉，另一组加用氟烷麻醉。分别于术前、术毕、术后6、12、24小时测定代谢物和同型半胱氨酸浓度，并比较两组间的差异。接受氟烷麻醉的新生儿对手术的激素反应降低，两组在肾上腺素、去甲肾上腺素、皮质醇浓度和胰岛素/高血糖素浓度的变化方面有显著差异。接受氟烷麻醉的新生儿的血糖和总酮体浓度的变化以及血浆非酯化脂肪酸浓度的变化也减少了。未补充氧化亚氮麻醉的新生儿，术中、术后尿3-甲基组氨酸/肌酐的比值明显升高，临床情况也更加不稳定。除非有特别的禁忌症，所有接受外科手术的新生儿都应该使用氟烷或其他麻醉剂进行强力麻醉，因为这会减少他们的应激反应，并提高他们在手术中和术后的临床稳定性。
Concern about the side effects of various anesthetic agents in newborn infants has led to the widespread use of anesthesia with unsupplemented nitrous oxide and oxygen with muscle relaxants is such patients. To investigate the efficacy of such a regimen 36 neonates undergoin operations were randomised to two groups: one group received anesthesia with nitrous oxide and curare alone and the other was additionally given halothan. Concentrations of metabolites and homones were measured before and at the end of operation and at six, 12, and 24 hours after operation and the values compared between the two groups. Neonates given halothan anaesthesia showed decreased hormonal responses to operation, with significant differences between the two groups in the changes in adrenaline, noradrenaline, and cortisol concentrations and the ratio of insulin to glucagon concentration. Changes in blood concentrations of glucose and total ketone bodies and plasma concentrations of non-esterified fatty acids were also decreased in neonates receiving halothane anaesthesia. Neonates given anaesthesia with unsupplemented nitrous oxide showed significantly greater increases in the urinary ratio of 3-methylhistidine to creatinine concentration and their clinical condition was also more unstable during and after operation. Unless specifically contraindicated potent anaesthesia with halothane or other anaesthetic agents should be given to all neonates undergoing surgical operations as it decreases their stress responses and improves their clinical stability during and after operation.