硬膜外自控镇痛对急性心肌缺血的老年患者血浆单胺类神经递质的影响

目的 观察硬膜外自控镇痛（PCEA）对急性心肌缺血的老年患者血浆单胺类递质的影响。方法 选择30例心肌缺血的老年患者随机分成两组：A组选择T3－T5椎间隙行硬膜外穿刺置入硬膜外导管，注入1％利多卡因5ml，测阻滞平面为T1－T6，按PCA泵持续治疗1周。PCEA治疗采用LCP模式。B组不用PCEA治疗，用硝酸酯类药物治疗。结果 A组和B组在治疗前血浆单胺类神经递质均升高，A组患者通过PCEA治疗后下降明显，1周后基本恢复正常值。B组下降幅度不明显。结论 PCEA能改善老年患者的心肌缺血，有效抑制血浆单胺类神经递质的释放，保持机体内稳态。

Effects of patient-controlled epidural analgesia on plasma monoamine neurotransmitter levels in elderly patients with acute myocardial ischemia

Objective To observe the effects of patient controlled epidural analgesia(PCEA) on plasma monoamine neurotransmitter level of elderly patients with acute myocardial ischemia.Methods Elected 30 myocardial ischemia elderly patients were divided randomly into two groups.In group A high epidural blockade of T 3 T 5 was performed by injecting 5ml of 1% lidocaine and flat blockade at T 1 T 6 was measured,afterwards PCEA was used for treatment for 1 succesive week,the mode of LCP was adopted in PCEA treatment.For group B nitrates rather than PCEA was accordingly applied for treatment.Results The plasma monoamine neurotransmitter levels both in group A and group B were higher than normal range before treatment.In group A the elevated plasma monoamine neurotransmitter levels decreased significantly and returned to normal range 1 week after PCEA was applied.But in group B the result was not ideal.Conclusion PCEA can ease acute myocardial ischemia of old patient.Restraint effectively the release of monoamine neurotransmitter and keep stability in organism.