摘要
目的 :探讨复合胸段硬膜外阻滞后全麻各期段维持所需麻醉深度的异氟醚MAC及对其用量的影响。方法 :6 0例择期行胃癌根治术的患者 ,随机分成两组 ,研究组 (Ⅰ )异氟醚吸入全麻复合胸段硬膜外阻滞组 ;对照组 (Ⅱ )单纯异氟醚吸入全麻组。连续监测麻醉各阶段的循环状态和MAC值 ,麻醉结束准确测量整个麻醉所用异氟醚量。结果 :两组术中镇痛良好 ,肌松满意 ,均无术中知晓。组 (Ⅰ )整个麻醉过程循环稳定 ,平均动脉压 (MAP)和心率(HR)与麻醉前相比均无显著性差异 (P >0 0 5 ) ,波动小。组 (Ⅱ )整个麻醉过程中循环波动较大 ,与麻醉前和组 (Ⅰ )相比 ,MAP和HR均有显著性差异 (P <0 0 5 ) ;组 (Ⅱ )术中各阶段持循环稳定和手术所需MAC均明显高于组 (Ⅰ ) (P <0 0 5 ) ,整个麻醉异氟醚用量较大 ,与组 (Ⅰ )相比差异显著 (P <0 0 5 )。结论 :异氟醚麻醉复合胸段硬膜外阻滞行胃癌根治术能有效抑制应激反应 ,保障血流动力学稳定 ,减少吸入全麻药用量 ,在较浅吸入全麻基础上顺利完成手术 。
Obejitive:To evaluate the effects of thoracic epidural block combined with inhalation general anesthesia on isoflurane MAC and isoflurane requirements in radical operation for carcinoma of stomath.Methods:Sixty patients,scheduled for elective radical operation for carcinoma of stomath,ASA Ⅰ~Ⅱ grade,were divided randomly into study group(group Ⅰ,n=30) isoflurane combined wih epidural block,and control group (group Ⅱ,n=30) isoflurane alone.Circulation state and MAC were recorded constantly.The total isoflurane requirements were measured exactly post-operation.Result:In group Ⅰ(epidural group),hemodynamics very stable during the whole operation,MAP and HR were to statistically difference than pre-anesthesia (P>0 05),MAC of isoflurane to maintain anesthesia and isoflurane requirements were lower than group Ⅱ(isoflurane alone)at different stages of surgery(P<0 05).In group Ⅱ,hemodynamics had obvious changes during anesthesia.when sustained multiple noxious stimuli,MAP and HR were increased markly,there were significantly difference compared with pre-anesthesia and group Ⅰ(P<0 05),the total dosages of isoflurane were increased markedly.Conclution:The thoracic epidural block combined with isoflurane anesthesia can decrease isoflurane requirements markedly and lowered the depth of inhalation anesthesia,fully supress the sress response and produce better hemodynamic stability,so is a kind of effective and safe anesthesia patterns.
出处
《黑龙江医学》
2000年第11期7-9,共3页
Heilongjiang Medical Journal
关键词
全麻
异氟醚
胸段硬膜外阻滞
麻醉
胃癌根治术
术中
吸入
结论
显著性差异
阶段
thoracic epidurl block isoflurane anesthesia radical operation for carcinoma of stomach MAC isoflurane requirements