腹部硬膜外阻滞复合全凭静脉麻醉对老年患者围术期鼻咽温度的影响

Influence of Abdominal Epidural Block Combined with General Anesthesia on Nose Pharynx Temperature of Elderly Patients in Perioperative Period

[目的]研究腹部硬膜外阻滞复合全凭静脉麻醉对老年患者围术期鼻咽温度的影响。[方法]选择2009年9月至2011年1月在我院择期行胃癌根治术老年患者40例(>65岁),美国麻醉师协会(ASA)Ⅱ～Ⅲ级,随机分成2组,I组采用腹部硬膜外阻滞复合全凭静脉麻醉,Ⅱ组采用全凭静脉麻醉。各组于诱导时开始,每隔30min记录鼻咽温度,直至手术结束。[结果]诱导后两组患者的鼻咽温度呈进行性降低,术毕值与诱导值比较差异显著(P<0.0l),I组鼻咽温度下降幅度(1.87±0.47)℃明显>Ⅱ组(1.24±0.30)℃(P<0.05)。两组的生命体征比较,差异无统计学意义(P>0.05)。[结论]腹部硬膜外阻滞复合全凭静脉麻醉过程中老年患者围术期鼻咽温度显著降低,围术期应采取保暖措施。

[Objective] To study the changing of core temperature on elderly patients during abdominal epidural block combined with general anesthesia. [Methods] Forty ASA Ⅱ-Ⅲ elderly patients undergoing elective surgery for gastric cancer were randomly divided into two groups. Group Ⅰ： abdonfinal epidural block combined with general anesthesia was performed. Epidural block was perfomaed at T 11-12. Group Ⅱ ：General anesthesia was perfomaed. Nose pharynx temperature was recorded every 30 min from the beginning of anesthesia induction to the end of the operation. [Results1 In two groups, nose pharynx temperature at the time of the end of the operation was sigmficandy lower than that at the time of anesthesia induction. The core temperature decreased more progressively in group 1 （1.87±0.47）,℃ than group Ⅱ （1.24±0.3）℃. [Conclusions] Perioperative mild hvpothermia developed progressively on elderly patients during abdonfinal epidural block combined with gemeral anesthesia. The protective measures should be taken actively.