全麻复合硬膜外麻醉在老年高血压病人开胸手术中的应用

Application of general anesthesia combined with epidural anesthesia in thoracotomy of senile hypertensive patients

目的 探讨全麻复合硬膜外麻醉在老年高血压病人开胸手术中应用的利弊。方法 将 60例拟行开胸手术的老年高血压病人 (ASA分级Ⅰ～Ⅱ级 )随机分为A、B两组 ,A组采用全麻复合硬膜外麻醉 ,B组单纯用全麻 ,观察两组手术期间循环功能和ECG的变化及全麻用药量和苏醒延迟的发生率。结果 A组病人术中循环功能较稳定 ,心肌缺血有所改善 ,全麻用药量较小 ,无苏醒延迟发生。结论 全麻复合硬膜外麻醉用于开胸手术的老年高血压病人更安全 ,能降低应激反应 ,改善心肌缺血 。

Objective To evaluate the advantages and disadvantages of general anesthesia combined with epidural anesthesia in thoracotomy of senile hypertensive patients.Methods Sixty senile hypertensive patients, ASA grade Ⅰ～Ⅱ,scheduled for thoracotomy, were randomly divided into group A(general anesthesia combined with epidural anesthesia,n=30) and group B(general anesthesia,n=30).The cardiac function, ECG, dosage of anesthetic and rate of awakening delay were observed during operation.Results The cardiac function of group A was more stable than that of group B; the dosage of anesthetic in group A was less than that in group B; myocardiac ischemia was improved and no awakening delay existed in group A.Conclusion The combination of general and epidural anesthesia can suppress the stress, improves myocardial ischemia, and depress rate of awaking delay. So it is safer. But hypotension and bradycardia must be prevented.