全麻联合硬膜外阻滞在胸科手术中的临床观察

Observation on the effect of combined general-epidural anesthesia in thoracic operation

目的:探讨全麻联合硬外阻滞用于胸科手术的麻醉效果,以及在术中血压(Bp)、心率(HR)的变化,术后的恢复情况,验证其麻醉的可行性及安全性。方法:30例胸科手术患者随机分为观察组(A组n=15)和对照组(B组n=15),A组采用全身麻醉联合硬膜外阻滞的方法,B组仅用全麻。结果:两组病例麻醉效果满意,全麻药用量A组明显少于B组,术毕至拔气管时间B组比A组延长,拔管后烦燥、躁动、疼痛的发生率A组比B组明显减少。结论:全麻联合硬膜外阻滞能有效减轻围手术期的应激反应,循环稳定,麻醉平稳,术毕清醒快、并发症少。术后镇痛又利于胸科术后病人咳嗽咳痰。

Objective：To explore the anesthetic effect of combined general-epidural anesthesia in thoracic operation, the change of blood pressure （BP） and heart rhythm（HR）,the condition of postoperative recovery,testify the feasibility and safety of anesthesia. Methods： 30 patients who received thoracic operation were divided randomly into the observation group（group A, n=15 ） and the control group（group B, n = 15 ）. The patients received combined general-epidural anesthesia in group A,then only general anesthesia in group B. Results：The anesthetic effect of two groups was satisfactory,the general anesthesia dosage in group A was significantly less than that in group B,the time of extubation in group B was longer than that in group A, the recurrent rate of fantod, restlessness, and pain after extubation in group A was significantly less than that in group B. Conclusions：Combined general-epidural anesthesia can decrease effectively the stress response during perioperative period, keep the stable of circulation and anesthesia,rapid recovery after operation and less complication, postoperative analgesia is more beneficial for patients＇ cough and sputum after thoracic operation.