全麻复合硬外麻醉应用于大型胸腹部手术的麻醉效果观察

Effect of general anaesthesia combined with epidural anesthesia for thorax and abdominal operations.

目的对比研究单纯全麻与全麻加硬膜外麻醉对胸部和腹部大型手术患者的循环、麻药用量、术后镇痛等指标的影响。方法120例ASAⅠ—Ⅱ级行择期胸、腹部大型手术患者随机分为两组,每组60例,Ⅰ组为全麻组,Ⅱ组为全麻加硬膜外麻醉组,诱导前硬膜外给予2%利多卡因5 m l,有麻醉平面后行全麻诱导,全麻用药与Ⅰ组相同,术后全麻组接静脉镇痛泵,全麻复合硬膜外组接硬膜外镇痛泵。结果两组血流动力学改变、苏醒速度、镇痛满意度结果对比差异有统计学意义(P<0.01)。结论全麻复合硬外麻醉能有效地抑制应激反应、在术野内提供良好的肌肉松驰,减少全麻药物用量,苏醒快,术后镇痛满意度高。是一种较为安全的麻醉方法。

Objective To investigate the effect of general anesthesia combined with epidural anesthesia in thorax and abdominal operation. Methods. 120 cases whose grade of ASA were Ⅰ and Ⅱ were divided into two groups randomly. One group ordy accepted general anaesthesia, and the other one accepted epidural anesthesia before induction of general anesthesia. They received different pump to relieve pain after operation. Some indexes were observed, including haemedynamics, speed of analepsia, and satisfaction of relief pain after operation, etc. Results There were significant difference in above indexes between this two groups （ P 〈 0.01 ）. Conclusion General anesthesia combined with epidural anesthesia may reduce the dosage of drugs, improve the speed of analepsia and the degree of satisfaction in pain relief after operation, and hence it is a more safe and effective anaesthesia method.