期刊文献+

胸段硬膜外麻醉的非镇痛作用 被引量:5

Non-analgetic effects of thoracic epidural anaesthesia
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摘要 胸段硬膜外麻醉(fhoracic epidural anesthesia,rrEA)被广泛用于心脏、胸部和腹部的手术及术后镇痛。然而,许多基础及临床研究都证实TEA除了减轻疼痛,还有更广泛的其他作用。TEA可以降低神经内分泌应激反应,对免疫和凝血系统也有积极的作用,减少围手术期并发症。此外,TEA导致的胸交感神经阻滞被建议用于围术期心、肺、胃肠道的保护。因此这项技术对于很多外科手术的预后有着重要的影响。此文针对TEA非镇痛方面的作用及新近关于TEA应用于重大手术的研究作一综述。 Thoracic epidural anaesthesia (TEA) are practised extensively for cardiac, thoracic and abdominal surgery, However, many experimental and clinical studies have shown that TEA may have effects far beyond pain relief. TEA may decrease the neuroendocrine stress response and reduce the number of perioperative complications. Furthermore, transient thoracic sympathectomy by TEA has been suggested to offer protective cardiac, pulmonary and gastrointestinal effects as well as positive immunological and coagulation properties. The technique is thus thought to have a significant impact on the outcome of major surgical procedures. This review will focus on these non-analgetic aspects of TEA, and will discuss the most important works published recently regarding outcome studies in patients undergoing major surgery and epidural anaesthesia.
出处 《国际麻醉学与复苏杂志》 CAS 2010年第1期56-59,共4页 International Journal of Anesthesiology and Resuscitation
关键词 胸段硬膜外麻醉 脏器功能保护 预后 Thoracic epidural anaesthesia Organ protection Outcome
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参考文献19

  • 1Kessler P, Aybek T, Neidhart G, et al. Comparison of Three Anesthetic Techniques for Off-Pump Coronary Artery Bypass Grafting: General Anesthesia, Combined General and High Thoracic Epidural Anesthesia, or High Thoracic Epidural Anesthesia Alone. Journal of Cardiothoracic and Vascular. J Cardiothorac Vasc Anesth, 2005,19(1): 32-39.
  • 2Oka T, Ozawa Y, Ohkubo Y. Thoracic epidural bupivacaine attenuates supraventricular tachyarrhythmias after pulmonary resection. Anesth Analg, 2001, 93(2): 253-259.
  • 3Licker M, Spiliopoulos A, Tschopp JM. Influence of thoracic epidural analgesia on cardiovascular autonomic control after thoracic surgery. Br J Anaesth, 2003, 91(4): 525-531.
  • 4Ganapathy S, Murkin JM, Dobkowski W, et al. Stress and inflarmnatoryresponse after beating heart surgery versos conventional bypass surgery: the role of thoracic epidural anesthesia. Heart Surg Forum, 2001, 4(4): 323-327.
  • 5陈国忠,李中言,窦元元,王金华,陈东生,林秀真.冠心病心力衰竭病人胸段硬膜外阻滞后心功能变化[J].临床麻醉学杂志,2002,18(9):476-477. 被引量:11
  • 6陈志扬,薛张纲,蒋豪.全麻复合胸段硬膜外阻滞对兔实验性心肌梗死的影响[J].中华麻醉学杂志,2000,20(10):618-620. 被引量:25
  • 7Scott NB, Turfrey DJ, Ray DA, et al. A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. Anesth Analg, 2001, 93(3): 528-535.
  • 8孟庆云,王克诚.开胸手术全麻复合胸部硬膜外阻滞对内分泌及循环功能的影响[J].中华麻醉学杂志,1993,13(5):366-368. 被引量:42
  • 9王国年,齐淑华,姜丽华,苗延生,李殿俊.国产异氟醚麻醉加胸段硬膜外阻滞对开胸手术内分泌和循环功能的影响[J].中华麻醉学杂志,1999,19(7):436-436. 被引量:41
  • 10Groeben H, Schafer B, Pavlakovic G, et al. Lung function under high thoracic segmental epidural anesthesia with ropivacaine or bupivacaine in patients with severe obstructive pulmonary disease undergoing breast surgery. Anesthesiology, 2002, 96(3): 536- 541.

二级参考文献17

  • 1蒋昭祥,朱立人,张鹤,刘正德,邵小玲.不同麻醉下手术病人血浆皮质醇浓度变化的观察[J].临床麻醉学杂志,1989,5(2):70-72. 被引量:2
  • 2孟庆云,王克诚.开胸手术全麻复合胸部硬膜外阻滞对内分泌及循环功能的影响[J].中华麻醉学杂志,1993,13(5):366-368. 被引量:42
  • 3张国楼,林桂芳.麻醉与儿茶酚胺[J].国外医学(麻醉学与复苏分册),1995,16(4):202-204. 被引量:41
  • 4师树英 卫生部继续医学教育委员会.心力衰竭的病理生理及治疗.国家级继续医学教育项目系列教材选编(心血管病分册),第1版[M].长春:长春出版社,1999.253.
  • 5张玉清,国外医学麻醉学与复苏分册,1986年,7卷,1期,62页
  • 6林桂芳,麻醉与内分泌,1990年
  • 7张国楼,国外医学.麻醉学与复苏分册,1995年,16卷,202页
  • 8孟庆云,中华麻醉学杂志,1993年,13卷,366页
  • 9Smiley RM,Pantuck CB,Joseph J,et al.Alterations of the adrenergic receptor system after thoracic and abdominal surgery[].Anesthesia and Analgesia.1994
  • 10Kelm M,Schrader J.Control of coronary vascular tone by nitric oxide[].Circulation Research.1990

共引文献107

同被引文献63

  • 1刘继云,佘守章,董原洪,索琨,阮祥才.不同浓度罗哌卡因高位硬膜外麻醉对循环呼吸功能的影响[J].广东医学,2002,23(S2):43-44. 被引量:2
  • 2彭丽云,叶益汉,杨少玲.不同浓度罗哌卡因在高胸段硬膜外麻醉的比较观察[J].国际医药卫生导报,2007,13(5):54-56. 被引量:1
  • 3雷晓鸣,薛荣亮,钞海莲,张珍妮.不同长效局麻药用于上胸段硬膜外阻滞对患者术中循环及肺功能的影响[J].临床麻醉学杂志,2007,23(6):483-484. 被引量:4
  • 4Soto RG, Fu ES. Acute pain management for patients undergoing thoracotomy[J]. Ann Thorac Surg, 2003, 75(4): 1349-1357.
  • 5Davies RG, Myles PS, Graham JM. A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy--a systematic review and meta-analysis of randomized trials[J]. Br J Anaesth, 2006, 96(4): 418-426.
  • 6Eason M J, Wyatt R. Paravertebral thoracic block-a reappraisal[J]. Anaesthesia, 1979, 34(7): 6384542.
  • 7Licker M, Spiliopoulos A, Frey JG, et al. Risk factors for early mortality and major complications following pneumonectomy for non-small ceil carcinoma of the lung[J]. Chest, 2002, 121(6): 1890-1897.
  • 8Grant RP. Con: every postthoracotomy patient does not deserve thoracic epidural analgesiaJ]. J Cardiothorac Vasc Anesth, 1999, 13(3): 355-357.
  • 9Manoj KK. Ultrasound-guided thoracic paravertebral block[J]. Techniques in regional anesthesia & pain management, 2009, 13 (3): 142-169.
  • 10Ltinnqvist PA, Mackenzie J, Soni AK, et al. Paravertebral blockade. Failure rate and complications [ J ]. Anaesthesia, 1995, 50 (9) : 813 - 815.

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