罗哌卡因硬膜外麻醉复合全麻在胆道手术中的应用

Effect of general anesthesia combined Ropivacaine epidural block to cardiovascular stress on patients with biliary tract opertions

目的探讨罗哌卡因硬膜外麻醉复合全麻在胆道手术患者麻醉中的应用。方法 126例胆道手术患者随机分为复合麻醉组及全麻组,两组患者均给予气管插管全麻,复合麻醉组复合罗哌卡因硬膜外麻醉,比较两组患者入室后(time 0,T0)、插管前(time 1,T1)、插管后(time 2,T2)、胆道操作时(time 3,T3)、拔管前(time 4,T4)、拔管后(time 5,T5)的血流动力学参数及麻醉不良反应发生情况。结果两组患者T0、T1、T2、T4、T5时间点SBP、DBP及HR水平无显著差异,T3时间点复合麻醉组SBP、DBP高于对照组,HR高于对照组,复合麻醉组术中麻醉不良反应发生率低于全麻组,两组麻醉后不良反应发生率无显著差异。结论罗哌卡因硬膜外麻醉复合全麻有利于维持胆道术中血流动力学稳定,增加麻醉安全。

Objective To investigate the application of Ropivacaine epidural block combined general anesthesia in anesthesia of biliary tract opertions. Methods A total of 126 cases of patients who would take biliary tract opertions were selected and randomized into general anesthesia groups （GAG） and combined anesthesia groups （CAG）, all patients taken general anesthesia with trachea cannula,patients in CAG combined epidural block with ropivacaine,parameter of hemodynamics were contrasted between GAG and CAG at going into operating room （time 0,T0）,before trachea cannula （time 1 ,T1）,after trachea cannula（time 2,T2）,when operating in biliary tract（time 3,T3）,before tracheal intubation（time 4,T4） and after tracheal intubation（time 5 ,T5）. incidence rate of adverse reaction were contrasted between GAG and CAG. Results Level of diastolic blood pressure （DBP）,systolic blood pressure （SBP） and heart rate （HR） was identical between GAG and CAG at T0,TI,T2,To,Ts,level of SBP,DBP and HR was higher in CAG than in GAG at T3,incidence rate of anesthesia adverse reaction was lower in CAG than in GAG during operations and was idectical after operations. Conclusion Epidural block with ropivacaine combined general anesthesia in anesthesia of biliary tract opertions is helpful for increasing stabilization of haemodynamics, improve anesthesia safety.