硬膜外阻滞联合全麻在胸科手术中的临床观察

Effect of combined general-epidural anesthesia in thoracic operatin

目的探讨全麻联合硬膜外阻滞用于胸科手术的麻醉效果,验证其麻醉的可行性及安全性。方法40例胸科手术患者随机分为观察组20例(Ⅰ组)和对照组20例(Ⅱ组),Ⅰ组采用全身麻醉联合硬膜外阻滞的方法,Ⅱ组仅用全麻。结果两组病例麻醉效果均满意,全麻药用量Ⅰ组明显少于Ⅱ组,术毕拔气管时间Ⅱ组比Ⅰ组延长,拔管后烦躁、躁动、疼痛的发生率Ⅰ组比Ⅱ组明显减少。结论全麻联合硬膜外阻滞能有效减轻围手术期的应激反应,循环稳定,麻醉平稳,术毕清醒快,并发症少。术后镇痛有利于胸科术后病人咳嗽咳痰。

Objective To explore the anesthetic effect of combined general-epidural anesthesia in thoracic operation,the change of blood pressure（BP） and heart rhythm（HR）,the condition of postoperative recovery,testify the feasibility and safety of anesthesia.Mehods 40 patients received thoracic operation were randomly divided into the observation group（groupⅠ,n=20） and the control group（gyoup Ⅱ,n=20）.The patients in group Ⅰ were treated with combined general-epidural anesthesia,whearas patients group Ⅱ with only general anesthesia. Results The anesthetic effect of two groups was satisfactory. The general anesthesia dosage in group Ⅰ was significantly less than that in group Ⅱ. The time of extubation groupB was longer than that in gyoup Ⅰ. The recurrent rate of fantod and restlessness pain after extuhation in group I was significantly less than then in group Ⅱ. Conclusions Combined general-epidural anesthesia can effectively decrease the stress response during perioperative period, keep the stable of circulation and anesthesia, rapidly recover after operation.