全麻联合硬膜外阻滞在宫颈癌手术中的应用

General Anesthesia Combined with Epidural Block in Surgery of Cervical Cancer

目的观察全麻联合硬膜外阻滞用于宫颈癌根治术中血流动力学的变化与麻醉效果。方法60例择期宫颈癌根治术病人随机分为两组各30例:A组(实验组)硬膜外阻滞联合静吸复合全麻,B组(对照组)单纯静吸复合全麻组。观察患者麻醉前、气管插管后、手术开始、手术2h、气管拔管时的BP、HR以及麻醉药用量,术毕自主呼吸恢复、拔管和完全清醒时间。A组采用硬膜外术后镇痛。结果A组整个手术期间血流动力学稳定,全麻药用量明显少于B组,拔管及完全清醒时间较B组明显缩短。结论全麻联合硬膜外阻滞用于宫颈癌手术患者血流动力学稳定,麻醉恢复期短,术后镇痛完全,具有临床应用价值。

Objective To investigate the changes in hemodynamics in general anesthesia combined with epidural block for cervical cancer radical mastectomy and anesthetic effect. Methods Sixty cervical cancer radical surgery patients were randomly divided into two groups of 30 cases each： group A（experimental grnup）,general anesthesia combined with epidural block and group B（control group）, anesthesia alone. We observed the BP and HR before anesthesia,after intubation,at surgery start,at 2h surgery and at the time of tracheal extubation,and observed the anesthetic dosage,the completed restoration of spontaneous breathing,extubation time and complete sober time. Group A was given postoperative epidural analgesia. Results Group A showed the hemodynamic stability during surgery, significantly less general anesthesia dosage and markedly shorter extubation time and completely sober time compared with group B. Conclusion The combined spinal and epidural block anesthesia for surgery in patients with cervical cancer shows hemodynamic stability,short recovery period and complete postoperative analgesia,with clinical value.