蛛网膜下腔可乐定及体外循环心脏手术对创伤的反应

Claudia Gissi da Rocha Ferreira, Sérgio Bernardo Tenório
{"title":"蛛网膜下腔可乐定及体外循环心脏手术对创伤的反应","authors":"Claudia Gissi da Rocha Ferreira,&nbsp;Sérgio Bernardo Tenório","doi":"10.1016/j.bjanes.2013.04.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><p>The intense trauma response triggered by cardiopulmonary bypass can lead to increased morbidity and mortality. The present study evaluated whether clonidine, a drug of the class of α-2 agonists, administered by spinal route, without association with local anesthetics or opioids, reduces this response in cardiac surgery with cardiopulmonary bypass.</p></div><div><h3>Method</h3><p>A total of 27 patients between 18 and 75 years old, divided by non-blinded fashion into a control group (15) and a clonidine group (12), were studied. All patients underwent identical technique of general anesthesia. Then, only the clonidine group received 1<!--> <!-->μg<!--> <!-->kg<sup>−1</sup> clonidine by spinal route. Levels of blood glucose, lactate and cortisol were measured at three consecutive times: T1, at the time of installation of invasive arterial pressure; T2, 10<!--> <!-->min after the first dose for cardioplegia; and T3, at the time of skin suture; and troponin<!--> <span>i</span> values at T1 and T3. The variation of results between T2-T1, T3-T2, and T3-T1 was also evaluated.</p></div><div><h3>Results</h3><p>There was a statistically significant difference only with respect to the variation in blood glucose in the clonidine group: T3-T2, <em>P</em> <!-->=<!--> <!-->.027, and T3-T1, <em>P</em> <!-->=<!--> <!-->.047.</p></div><div><h3>Conclusions</h3><p>Spinal clonidine at a dose of 1<!--> <!-->μg<!--> <!-->kg<sup>−1</sup> did not decrease blood measurements of troponin, cortisol, or lactate. Blood glucose suffered a more moderate variation during the procedure in the clonidine group. This fact, already reported in the literature, requires further investigation to be clarified.</p></div>","PeriodicalId":100199,"journal":{"name":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","volume":"64 6","pages":"Pages 395-399"},"PeriodicalIF":0.0000,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjanes.2013.04.011","citationCount":"0","resultStr":"{\"title\":\"Clonidina subaracnoidea y respuesta al trauma en cirugías cardíacas con circulación extracorpórea\",\"authors\":\"Claudia Gissi da Rocha Ferreira,&nbsp;Sérgio Bernardo Tenório\",\"doi\":\"10.1016/j.bjanes.2013.04.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and objectives</h3><p>The intense trauma response triggered by cardiopulmonary bypass can lead to increased morbidity and mortality. The present study evaluated whether clonidine, a drug of the class of α-2 agonists, administered by spinal route, without association with local anesthetics or opioids, reduces this response in cardiac surgery with cardiopulmonary bypass.</p></div><div><h3>Method</h3><p>A total of 27 patients between 18 and 75 years old, divided by non-blinded fashion into a control group (15) and a clonidine group (12), were studied. All patients underwent identical technique of general anesthesia. Then, only the clonidine group received 1<!--> <!-->μg<!--> <!-->kg<sup>−1</sup> clonidine by spinal route. Levels of blood glucose, lactate and cortisol were measured at three consecutive times: T1, at the time of installation of invasive arterial pressure; T2, 10<!--> <!-->min after the first dose for cardioplegia; and T3, at the time of skin suture; and troponin<!--> <span>i</span> values at T1 and T3. The variation of results between T2-T1, T3-T2, and T3-T1 was also evaluated.</p></div><div><h3>Results</h3><p>There was a statistically significant difference only with respect to the variation in blood glucose in the clonidine group: T3-T2, <em>P</em> <!-->=<!--> <!-->.027, and T3-T1, <em>P</em> <!-->=<!--> <!-->.047.</p></div><div><h3>Conclusions</h3><p>Spinal clonidine at a dose of 1<!--> <!-->μg<!--> <!-->kg<sup>−1</sup> did not decrease blood measurements of troponin, cortisol, or lactate. Blood glucose suffered a more moderate variation during the procedure in the clonidine group. This fact, already reported in the literature, requires further investigation to be clarified.</p></div>\",\"PeriodicalId\":100199,\"journal\":{\"name\":\"Brazilian Journal of Anesthesiology (Edicion en Espanol)\",\"volume\":\"64 6\",\"pages\":\"Pages 395-399\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2014-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.bjanes.2013.04.011\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brazilian Journal of Anesthesiology (Edicion en Espanol)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S225549631400083X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brazilian Journal of Anesthesiology (Edicion en Espanol)","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S225549631400083X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景与目的体外循环引发的强烈创伤反应可导致发病率和死亡率的增加。本研究评估了经脊柱给药而不与局部麻醉剂或阿片类药物联用的α-2激动剂类药物可乐定是否能降低体外循环心脏手术患者的这种反应。方法选取年龄在18 ~ 75岁的患者27例,采用非盲法分为对照组(15例)和可乐定组(12例)。所有患者均采用相同的全身麻醉技术。然后,只有可乐定组经脊髓途径给药1 μg kg−1可乐定。连续三次测量血糖、乳酸和皮质醇水平:T1,安装有创动脉压仪时;T2,第一次给药后10min;T3为皮肤缝合时;T1和T3时肌钙蛋白i值。并对T2-T1、T3-T2和T3-T1之间的结果差异进行评价。结果只有可乐定组的血糖变化有统计学意义:T3-T2, P = 0.027, T3-T1, P = 0.047。结论脊髓可乐定剂量为1 μg kg−1不会降低肌钙蛋白、皮质醇或乳酸的血液测量值。在治疗过程中,可乐定组的血糖变化较为温和。这一事实已在文献中报道,需要进一步调查才能澄清。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clonidina subaracnoidea y respuesta al trauma en cirugías cardíacas con circulación extracorpórea

Background and objectives

The intense trauma response triggered by cardiopulmonary bypass can lead to increased morbidity and mortality. The present study evaluated whether clonidine, a drug of the class of α-2 agonists, administered by spinal route, without association with local anesthetics or opioids, reduces this response in cardiac surgery with cardiopulmonary bypass.

Method

A total of 27 patients between 18 and 75 years old, divided by non-blinded fashion into a control group (15) and a clonidine group (12), were studied. All patients underwent identical technique of general anesthesia. Then, only the clonidine group received 1 μg kg−1 clonidine by spinal route. Levels of blood glucose, lactate and cortisol were measured at three consecutive times: T1, at the time of installation of invasive arterial pressure; T2, 10 min after the first dose for cardioplegia; and T3, at the time of skin suture; and troponin i values at T1 and T3. The variation of results between T2-T1, T3-T2, and T3-T1 was also evaluated.

Results

There was a statistically significant difference only with respect to the variation in blood glucose in the clonidine group: T3-T2, P = .027, and T3-T1, P = .047.

Conclusions

Spinal clonidine at a dose of 1 μg kg−1 did not decrease blood measurements of troponin, cortisol, or lactate. Blood glucose suffered a more moderate variation during the procedure in the clonidine group. This fact, already reported in the literature, requires further investigation to be clarified.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信