全身麻醉复合硬膜外阻滞对上腹部手术患者术后清醒期的影响

Effects of General Anesthesia Combined with Epidural Block on Postoperative Recovery Period in Patients Undergoing Upper Abdominal Operation

目的探讨全身麻醉复合硬膜外阻滞对上腹部手术中血流动力学及术后清醒的影响。方法择期上腹部手术60例,根据抽签法随机分为全身麻醉(A)组和全身麻醉复合硬膜外阻滞(B)组。记录两组患者全身麻醉用药量、术中知晓、术后清醒时间、苏醒期躁动、血压、心率等情况。结果两组患者仅B组存在可疑知晓2例,均无一例肯定术中知晓。异丙酚、芬太尼用量及苏醒期躁动发生率,B组明显少于A组(P<0.05);术后清醒时间、拔管时间,B组明显短于A组(P<0.05);两组患者术后同时点收缩压、舒张压及心率比较,B组低于A组,差异有统计学意义(P<0.05)。结论全身麻醉复合硬膜外阻滞应用于上腹部手术安全有效,术中循环稳定,减少全麻药的用量,利于患者术后快速清醒,值得临床推广。

Abstract Objective To study the effect of general anesthesia combined with epidural block on postoperative recovery period in pa- tients undergoing upper abdominal operation. Methods Sixty patients were randomly divided into two groups. The observation group （group A） was received general anesthesia alone, and the control group （group B） was received general anesthesia combined with epidural block. The change of blood pressure and heart rate,anesthetic doses, emergence agitation, intraoperative awareness were obversed in perio- perative period. Results There was not intraoperative awareness in all of them. The doses of propofol and fentanl, incidence rate of post- operative awake were obviously lower in group B compared with group A. The time of awake and extubation were apparently shorter in group B compared with group A. There were decreased SBP, DBP and HR at the same time in group B compared with group A,the difference of which is of statistic significance. Conclusion General anesthesia combined with epidural block was effective and safety, can cause more stabled hemodynamics, faster recover from anesthesia and is an available method during upper abdominal operation.