高位硬膜外麻醉在婴幼儿动脉导管未闭手术中的应用

High epidural anesthesia for repair of patent ductus arteriosus in infants

目的 观察高位硬膜外麻醉在婴幼儿动脉导管未闭（ＰＤＡ）手术中的应用。方法 全部患儿全麻插管后，均采用高位硬膜外麻醉，穿刺部位选择在Ｔ７～８ 或Ｔ８～９，阻滞药物为利多卡因和丁哌卡因混合液，患儿术后拔管。观察动脉导管结扎前后的心血管反应。结果 辅以小剂量（０５～０１）％的吸入性全麻药，降压平稳，阻断前的ＳＰ、ＤＰ、ＭＡＰ与硬膜外前比较有显著性差异，阻断ＰＤＡ 后血压缓慢上升。结论 高位硬膜外麻醉使心血管反应稳定，对循环系统的扰乱程度轻。

Objective To evaluate the feasibility of high epidural anesthesia for repair of patent ductus arteriosus CPDA in infants.Methods High epidural anesthesia at T 7 8 or T 8 9 with mixture of lidocaine and bupivacaine was utilized as an alternative to general anesthesia.The patients were extubated soon after surgical repair.Cardiovascular parameters was observed before and after ligation procedure.Results The hypotension induced with enflurane or isoflurane 0.5% 1% intermittent inhalation agents was very effective and steady.SP,DP and MAP before ligation decreased significantly compared with those before epidural anesthesia.The blood pressure increased very slowly after ligation.Conclusion High epidural anesthesia for PDA repair can hardly affect cardiovascular status and blunt the stress response.