全麻硬膜外复合麻醉对维吾尔族上腹部手术病人的影响

The influence of thoracic epidural anesthesia combined with general anesthesia on upper abdomen operation in Uighur patients

目的观察全麻硬膜外复合麻醉对维吾尔族上腹部手术病人血流动力学及血糖的影响。方法随机将择期上腹部维吾尔族手术病人30例分为两组(n=15),A组先行硬膜外穿刺置管,成功后用芬太尼4μg/kg、维库溴铵0.1mg/kg、咪唑安定0.15mg/kg、异丙酚4mg/kg诱导行气管插管,用异氟醚吸入和异丙酚3mg/(kg·h)恒速输注维持麻醉,并于切皮前由硬膜外导管注入局麻药;B组仅为单纯气管插管全麻。分别监测术前、全麻诱导后、插管后5min及术毕的血流动力学,观察两组全麻药用量及血糖变化情况。结果A组全麻药用量较B组显著减少(P<0.05),血流动力学及血糖无明显变化(P>0.05);B组心率及收缩压、血糖在插管后5min较A组明显升高(P<0.05)。结论全麻硬膜外复合麻醉对维吾尔族上腹部手术血流动力学及血糖影响轻微,但应注意硬膜外局麻药及时追加,以防麻醉减浅和病人术中知晓的发生。

Objective To obseve the influence of thoracic epidural anesthesia combined with general anesthesia on upper abdomen operation and on hemodynamics, the level of glucose in Uighur patients .Methods 30 cases of Uighur patients on undergoing upper abdomen operation were separated into two groups at random(n=15).Group A were induced with fentanyl 4μg/kg,vecruonium 0.1mg/kg,midazolam 0.15mg/kg and propofol 4mg/kg after succeeding in puncturing putting and managing epidural.Keep anaesthetizing by isoflurane inhalation and propofol 3mg/(kg·h) iv constantly,poured local anesthetics into epidural before cutting covers.Group B were simply general anesthetized only.Monitoring the hemodynamics before operation,after inducing 5 minutes and when the operation finished,observe the whole anesthetic consumption, the hemodynamics and the glucose changing. Results Group A was remarkably lower at the whole anesthetic consumption (P<0.05), the hemodynamics and the glucose changed indistinctively(P>0.05). Conclusion Thoracic epidural anesthesia combined with general anesthesia on upper abdomen operation influenced slightly to the hemodynamics and the glucose in Uighur patients but add to local anesthetics into epidural in time to prevent low anaesthetize and awareness effectively during general anesthesia.