不同局麻药用于上胸段硬膜外麻醉对心率变异性及肺功能的影响

Effects of different local anesthetics on heart rate variability and pulmonary function during upper thoracic epidural anesthesia

目的观察不同局麻药用于上胸段硬膜外麻醉对心率变异性及肺功能的影响.方法上胸段硬膜外麻醉下行手术患者60例随机分为A组(20g/L氯普鲁卡因组,n=30),B组(15g/L利多卡因,n=30),观察其阻滞前、阻滞后5,10,15,20,30min时HR,SBP,DBP,SpO2及HRV和Vc,FVc,FVc1,MMV的变化.结果A组阻滞后5,10,15min较阻滞前及B组HRV,HR,SBP,DBP均有所下降(P<0.05).A组及B组于阻滞后10min VC,FVC,FVc1,MMV都较阻滞前下降(P<0.05).结论用20g/L氯普鲁卡因和15g/L利多卡因行上胸段硬膜外阻滞可降低交感神经张力、减慢心率及降低血压.

AIM： To investigate the effects of different local anethestics on the heart rate variability （HRV） and pulmonary function during upper thoracic epidural anesthesia. METHODS： Sixty cases subjected to selective operations under upper thoracic epidural anesthesia were randomly divided into 2 groups： group A （ 20 g/L chloroprocaine, n = 30） and group B （15 g/L lidocaine, n=30）. The changes of HR, SBP, DBP, SaO2, HRV, Vc, FVc, FVcl and MMV before anesthesia and ,5, 10, 1,5, 20, .30 min after anesthesia were recorded and analyzed respectively. RESULTS： HRV, HR, SBP and DBP in group A 5, 10, 15 min after anesthesia decreased significantly compared with those before anesthesia and those in group B （ P 〈 0.05 ）. Vc, FVc, FVc1 and MMV at 10 min after anesthesia in both groups decreased significantly compared with those before anesthesia （ P 〈 0.05 ）. CONCLUSION： Thoracic epidural anesthesia with both 20 g/L chloroprocaine and 15 g/L lidocaine can reduce sympathetic tension, heart rate and blood pressure.