吸入全麻和吸入全麻联合硬膜外麻醉对胃癌根治术患者清醒时MAC的影响

Comparison of Effects of General Anesthesia and Combined General-Epidural Anesthesia on MAC-Awake of Isoflurane in Patients Undergoing Gastrectomy

目的：比较吸入全麻和吸入全麻联合硬膜外麻醉对术后清醒时MAC和Steward苏醒评分的影响。方法：30例择期行胃癌根治术的患者，随机分成两组：吸入全麻组（全麻组）和吸入全麻联合硬膜外麻醉组（联合组），每组15例。联合组硬膜外给予1．6%利多卡因12～14ml，两组均采用异丙酚2mg／kg和琥珀胆碱1．5mg／kg诱导插管，用维库溴铵、异氟醚维持麻醉，两组异氟醚用量相同。手术结束时快速洗出体内异氟醚，进行Steward苏醒评分。结果：全麻组清醒MAC为（0．40±0．06）％，Steward苏醒评分4．10±0．04；联合组清醒MAC为（0．25±0．05）％，Steward苏醒评分为4．70±0．05。结论：吸入麻醉联合硬膜外麻醉术后清醒时MAC降低，Steward苏醒评分高。

Objective：To determine the awakening concentration of isoflurane and evaluate the emergence from anesthesia in the presence and absence of epidural block. Methods ：Thirty patients aged 45～65 years undergoing elective radical gastreetomy were randomly divided into general anesthesia group （GA, n = 15） and combined general-epidural anesthesia group（CGEA,n=15）. In CGEA group epidural block was given a dose of 12～14 ml of 1.6% lidocaine. General anesthesia was induced with propofol 2.0 mg/kg and suceinylcholine 1. 5 mg/kg. Anesthesia was maintained with similar concentration of isoflurane in two group. At the end of operation isoflurane was washed out quickly. The end-tidal isoflurane concentration was recorded as MAC-awake and Steward score was evaluated. Results ： MAC-awake of isoflurane was 0.4% in GA group and 0.25% in CGEA group. Steward score was 4.1 in GA group and 4.7 in CGEA group. Conclusion：Epidural block with lidoeaine reduces the MAC-awake. Steward score is higher in CGEA group than that in GA group.