在接受消化内镜检查的患者中,麻醉药对炎症和神经内分泌免疫反应的影响
Denisa-Ancuța Popa-Ion1, Lidia Boldeanu2, Dan-Ionuț Gheonea3
1Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Clinics and practice
|June 26, 2024
概括
普罗波与芬太尼在下消化道内镜检查期间显著降低了免疫和神经内分泌反应. 这种组合为无痛手术提供了一个更好的替代方案,与没有麻醉或单独使用醇相比.
科学领域:
- 麻醉学 麻醉学
- 免疫学 免疫学 免疫学
- 神经内分泌学神经内分泌学
背景情况:
- 下消化道内镜需要麻醉,可能会影响患者的生理标志物.
- 了解麻醉剂对炎症和甲醇胺的作用对于患者的安全和结果至关重要.
研究的目的:
- 在下消化道内镜检查期间,研究麻醉药对血清炎症标志物和甲基荷胺的影响.
- 为了比较没有麻醉的效果,propofol和propofol与芬太尼.
主要方法:
- 120名患者被分为三个组:没有麻醉 (L1), (L2) 和与芬太尼 (L3).
- 在三个时间点测量了上腺素 (EPI),上腺素 (NE),TNF-α,IL-4,IL-6,IL-8和IL-10的血清水平:内镜前,内镜期间和内镜后.
- 进行了统计分析,以比较不同组和时间点之间的标记物度.
主要成果:
- 麻醉组 (L2,L3) 与没有麻醉组 (L1) 相比,在所有时间点都显示了较低的甲醇胺和白蛋白水平.
- 与Propofol单独 (L2) 相比,Propofol与芬太尼 (L3) 在手术后2小时显示出明显较低的标志物水平.
- 在L2中的普罗波福尔剂量与NE,EPI和细胞因子水平相关,表明剂量依赖的效果.
结论:
- 普罗波与芬太尼结合,在下消化器内镜检查期间有效抑制全身免疫和神经内分泌反应.
- 这种麻醉组合在减轻生理应激反应方面优于单独的propofol或没有麻醉.
- 这些发现支持使用propofol和fentanyl来增强患者的康复和减少内镜手术期间的全身激活.
相关概念视频
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
71
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
71
01:24General Anesthesia: Overview
209
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
209
01:24Parenteral Anesthetics: Overview
117
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
117
01:22Stages of General Anesthesia
413
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
413
01:20Inhalational Anesthetics: Overview
260
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
260
01:25Endoscopic Procedures II: Colonoscopy
79
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
79