术后硬膜外自控镇痛对血浆神经肽Y水平的影响

目的 观察术后硬膜外自控镇痛（ＰＣＥＡ）对血浆神经肽Ｙ（ＮＰＹ）水平的影响。方法 ５８例胸外科手术病人随机分为ＰＣＥＡ组（２８例）和对照组（３０例）。ＰＣＥＡ组病人手术后采用硬膜外自控镇痛，维持视觉模拟评分（ＶＡＳ）〈３分，对照组根据需要间断肌注哌替啶。采用放射免疫法测定麻醉前、手术结束、术后２４ｈ和４８ｈ血浆ＮＰＹ和血清皮质醇浓度。结果 两组病人手术结束时血浆ＮＰＹ及血清皮质醇浓度均较麻醉前明显

Effects of postoperative patient-controlled epidural analgesia on plasma neuropeptide Y

Objective To observe the effects of postoperative patient controlled epidural analgesia(PCEA) on plasma neuropeptide Y(NPY) Methods Fifty eight patients scheduled for thoracic surgery, were randomly divided into PCEA group(n=28) and control group(n=30) After operation, patient controlled epidural analgesia was applied in PCEA group and in control group pethidine I M was given intermittently The plasma NPY and serum cortisol concentrations were measured at pre anesthesia,the end of operation,and 24h and 48h after operation by radioimmunossay Results Compared with the baselines, plasma NPY and serum cortisol levels increased significantly at the end of operation in both groups ,without the obvious differences between both groups The plasma NPY level restored to the baseline in PCEA group 24h after operation, and in control group was significantly higher 24h after operation than the besaline and restored to the besaline 48h after operation The serum cortisol level was kept higher level 24h after operation and restored to the baseline 48h after operation in PCEA group, and in control group increased significantly 24h and 48h after operation as compared with the baseline The plasma NPY level 24h after operation and serum cortisol level 24h and 48h after operation were lower markedly in PCEA group than those in control group Conclusions The PCEA can effectively depress the increase of plasma NPY and serum cortisol induced by postoperative pain in patients undergoing thoracic surgery