不同种类的局麻药硬膜外麻醉复合吸入麻醉对异氟醚MAC值的影响

The Affect of MAC of the Isoflurane at General Combined with Epidural Anesthesia with Different Kinds of Local Anesthetic

目的观察利多卡因和丁卡因硬膜外联合全麻对异氟醚MAC的影响。方法78例胆囊切除病人随机双盲分为四组,Ⅰ、Ⅱ、Ⅲ组均用硬膜外联合全麻,分别用1%利多卡因、0.15%丁卡因和其混合液做硬膜外麻醉,并吸入异氟醚全麻,Ⅳ组单纯吸入异氟醚全麻做对照。用电刺激左肩C5水平上下浮动法测异氟醚的MAC值。结果3组硬膜外联合全麻组异氟醚的MAC分别是:0.67±0.097%、0.68±0.084%、0.61±0.103%,3组间无显著差异;而全麻对照组的MAC为1.15±0.088%,硬膜外联合全麻组与全麻对照组比较有显著差异,可以显著降低异氟醚的MAC。结论利多卡因和丁卡因硬膜外联合全麻可以降低异氟醚的MAC值,但利多卡因和丁卡因及其混合液组中无显著差别,且表现相加作用,其作用机制可能一致。

Objective To observe the effect of MAC of the isoflurane at the general combined with epidural anesthesia with lidocaine and dicaine. Methods 78 cases of the cholecystectomy patients randomly double - blindly divided Ⅳ groups. General combined with epidural anesthesia were performed at the Ⅰ、Ⅱ、Ⅲ groups. And general anesthesia were performed at the contronal group. The MAC of the isoflurane are checked with up - and - down method with electronic stimulation at left on C5 leveral. Results The MAC of the three observed groups of the general combined with epidural anaesthesia were 0.67 ± 0. 097% .0.68 ± 0. 084% .0.61 ± 0. 103 % differently. There is no siginificant difference. But the MAC of the general contronl group is 1.15 ± 0. 088%. There are siginificant difference with the three observed groups ,The MAC of the isoflurane can be reduced with general combined with epidural anesthesia. Coinelousions The MAC the isoflurane can be reduced with general combined with epidural anaesthsia significantly compared with singal general anesthesia. And there are no significant different in the three observed groups. It is the pulsing action with lidocaine combined with dicaine at epidural anesthesia. The mechanism of anaesthesia with lidocaine or dicaine supposed to be the same.