氟芬合剂防治胆系手术牵拉反应的临床观察

Clinical Observation of Innovar Preventing and Curing the Stretch Reflex in Biliary Tree’s Operation

目的观察氯芬合剂防治胆系手术牵拉反应的效果。方法观察100例ASAⅠ～Ⅱ级均无心肺疾病的胆系手术患者的牵拉反应。将100例患者随机分为三组,即对照组(A组),胆囊颈部1%普鲁卡因封闭组(B组),硬膜外腔注射氟芬合剂(氟哌啶2.5mg+芬太尼0.05mg)+阿托品0.5mg组(C组)。结果对照组和B组在五种不同状态(麻醉前、麻醉后10min、入腹、探查及剥离胆囊、术毕)下的HR、SP、DP相对比,有显著差异(P<0.05),对照组牵拉反应明显,B组在胆囊颈部封闭之前牵拉反应也明显;C组在五种不同状态下的HR、SP、DP相对比,无明显差异(P>0.05),几乎无牵拉反应表现。结论硬膜外腔注射氟芬合剂+阿托品0.5mg在胆系手术中能有效的防治牵拉反应,避免胆心反射发生。

Objective To observe the effect of innovar preventing and curing the stretch reflex in biliary tree＇s operation. Methods 100 ASA I -Ⅱ patients＇stretch reflex, which were reflexed by the operations patients with biliary tree problems but no heart and lung diseases,were researched. They are divided into three groups at random：those are control group（group A）, cholecysts＇s cervix with 1% Procaine closed down group（group B ）, and epidural space injection with Innovar（droperidol 2.5mg ＋ Fentanyl 0.05mg） and Atropine0.5mg group （group C ）. Resuits The control group and the group B＇s HR,SP,DP had distinct discrepancy under five different condition（those were before anesthesia, 10minutes after it,in the abdomen, exploration and peeling of the cholecyst,and with all finished）. This means that P 〈 0.05 and the control group＇s stretch reflex was obvious as well as the group B before the cervix is closed down; however,C group has no distinct discrepency under the same five conditions,nearly with no stretch reflex. Conclusion Expidural apsce injection with Innovar and Atropin 0.5mg can efficiently prevent the stretch reflex from happening,so as to avoid the reflex of gallbladder and heart.