Effect of isoflurane anaesthesia and surgery on carbohydrate metabolism and plasma cortisol levels in man.

The present study was undertaken to investigate in nine male surgical patients the effects of isoflurane anaesthesia alone on the carbohydrate metabolism by determining plasma growth hormone (GH), insulin, blood glucose, and cortisol, and to compare them with the effects of anaesthesia associated with surgical operations. Determination of plasma GH, insulin, cortisol, and blood glucose were made simultaneously before induction of isoflurane anaesthesia, after maintenance of anaesthesia for 15 minutes and 30 minutes and during and after conclusion of the operation. Plasma GH concentrations showed a significant elevation during isoflurane anaesthesia, and maintained a similar high level one hour after the start of the operation. An insignificant elevation in plasma insulin level and significant increases in blood glucose were noted during anaesthesia and operation. Plasma cortisol levels increased insignificantly during anaesthesia, but increased markedly during operation. Our observations would suggest that the increased blood level of GH and elevated blood cortisol play a part in the increase of blood glucose during isoflurane anaesthesia and surgical operations in man.     

Carbohydrate metabolism during fasting in chronic hemodialysis patients

Carbohydrate metabolism was studied during a 72-hr fast in 11 nondiabetic endstage renal disease (ESRD) patients on chronic hemodialysis and six normal subjects. Blood was obtained every 12 hr for metabolic substrate, insulin, and potassium concentrations. Serum potassium concentrations were significantly higher in the ESRD patients at the end of each fasting day, and two patients were removed before completion of the fast when severe hyperkalemia developed. Mean blood glucose, alanine, pyruvate, beta-hydroxybutyrate, and serum insulin concentrations were similar in the two groups. Mean blood lactate concentration tended to be higher in the ESRD group. Mean blood acetoacetate and plasma free fatty acid (FFA) concentrations were lower in the ESRD group. When compared to serum insulin levels, the FFA concentration was lower in the ESRD group.     

Effect of lumbar epidural anaesthesia on plasma Cortisol levels in children

The cortisol response to surgery was studied in two groups of children one to eight years old during the first 24 hours after lower abdominal or peripheral surgery. The children were randomly allocated to a control (C) group (n = 6) or an epidural (E) group (n = 7). In Group C, surgery was performed under general anaesthesia and postoperative pain relief was achieved by using non-narcotic analgesics only. In Group E, lumbar epidural anaesthesia was combined with light general anaesthesia and postoperative pain relief was achieved by intermittent doses of bupivacaine administered through an epidural catheter. Cortisol levels were assessed before surgery (C), at the end of surgery (H0), at the 3rd, 6th, 12th and 24th postoperative hours (H3, H6, H12, H24). In Group C, cortisol levels increased significantly at H0, H3 and H6, whereas in Group E, a significant decrease was observed at H0 and a significant increase at H12. Mean cortisol values at H0 and H24 were significantly lower in Group E, when compared with those measured in Group C. In Group E, all postoperative cortisol values remained within the normal range, despite the low level of sensory blockade achieved. This suggests that minimal doses of epidural bupivacaine are effective in decreasing the endocrine stress response to surgery in children. This could be of clinical relevance in high-risk children with poor nutritional status. In Group C, the cortisol response remained altered for a longer period of time.     

人类性交活动对生殖激素水平的影响

本课题研究性交对促性腺激素与性腺激素水平的影响，并观察激素变化与性高潮的发生有无相关。结果男子性交后睾酮（Ｔ）水平升高２．１９±０．９０μｇ／Ｌ（ｘ±ＳＥ，Ｐ＜０．０５，ｎ＝９），而女子性交后雌二醇（Ｅ２）水平降低５２．００±１４．４６ｍｇ／Ｌ，Ｐ＜０．０２，ｎ＝７），其它激素水平无显著意义的变化。９男中６名出现性高潮，１名性高潮未出现者Ｔ亦升高６．６μｇ／Ｌ，而１名性高潮出现者的Ｔ反降低０．４μｇ／Ｌ。７女中６名未出现性高潮，但７人的Ｅ２均降低。可见激素变化与性高潮间未见相关。性交后性腺激素变化的意义有待进一步研究。     

Plasma levels of vitamin E and lipoperoxide during paediatric anaesthesia

We measured plasma levels of vitamin E (total tocopherol) and lipoperoxide in seventeen neonates (less than 10 days), twenty infants (1-12 months) and ten children (1-5 years) during anaesthesia. The seventeen neonates were randomly divided into two groups; seven who received 30 mg X kg-1 of alpha-tocopheryl acetate intramuscularly before anaesthesia and ten who did not. The 20 infants were divided into three groups: Group 1: eight infants who did not receive vitamin E; Group 2: six who received 30 mg X kg-1 of alpha-tocopheryl acetate orally for three days before anaesthesia; Group 3: six who received 30 mg X kg-1 of alpha-tocopheryl acetate intramuscularly three hours before anaesthesia. In the neonates who did not receive alpha-tocopheryl acetate, plasma vitamin E and lipoperoxide levels were unchanged following surgery. In Group 1 infants, plasma vitamin E levels decreased (p less than 0.05) and plasma lipoperoxide levels increased (p less than 0.05). In both neonates who received vitamin E and Group 3 infants the mean plasma vitamin E levels increased significantly (p less than 0.05) following surgery. In Group 2 infants, the levels of plasma vitamin E before surgery were high, as compared to the other groups: however, plasma vitamin E levels decreased following surgery. In the children, the plasma vitamin E levels were unchanged, while the plasma lipoperoxide levels decreased significantly (p less than 0.05) during anaesthesia. It is suggested from our studies that plasma vitamin E levels decrease and plasma lipoperoxide levels increase during anaesthesia and surgery in infants; however, those levels are unchanged in neonates.     

乌拉地尔对高血压患者血浆4种神经肽含量的影响

目的 观察乌拉地尔（ＵＲＡ）对高血压患者血浆４种神经肽：内皮素（ＥＴ）、降钙素基因相关肽（ＣＧＲＰ）、神经肽Ｙ（ＮＰＹ）及神经降压素（ＮＴ）水平的影响。方法 选择麻醉前高血压患者２０例。于麻醉诱导前静脉注射ＵＲＡ０．５ｍｇ／ｋｇ。应用放射免疫方法测定ＵＲＡ治疗前后血浆４种神经肽的水平,并以２０例健康者作对照。结果 高血压组血浆ＥＴ、ＮＰＹ水平明显高于正常组（Ｐ〈０．０１）、血浆ＣＧＲＰ、ＮＴ水平明