下腹部手术硬膜外腔与静脉辅用氟芬合剂的比较观察

Comparision and observation of epidural and intravenous innovar during lower abdominal operation

目的 :为减轻引起术中牵拉反射及术后恶心、呕吐 ,采用硬膜外腔注射氟芬合剂并与静脉应用比较。方法 :将 4 8例腹部手术患者分成两组行硬膜外麻醉 ,开皮前分别静脉、硬膜外腔注入等量氟芬合剂 ,记录观察术中SpO2 变化 ,牵拉反射及术后恶心情况进行比较。结果 :静脉组术中SpO2 明显下降 ;抑制牵拉反射略优于硬膜外组 ;恶心、呕吐评估两组间无显著差异。结论 :硬膜外麻醉下行下腹部手术 ,术中须辅助用药消除牵拉反射 ,经硬膜外腔注药可能因缓慢渗透入脑脊液作用于中枢 ,作用缓和、持久。此法可用于术中辅助用药。

Objective We have adopted the comparative method of epidural and intravenous innovar during lower abdominal operations in order to relieve the affects of the post operative nausea,vomitting(PONV)and visceral stetch reflexion caused by the operation.Method Forty-eight patients in lower abdominal operation were divided randomly into 2 groups under epidural block.At the beginning of operation,Fentanyl 1μg/kg and droperdol 0 05mg/kg were administered intravenously in Group Ⅰ while the same dosed of the drug were given to Group Ⅱ epidurally together with the local anesthetics.The changes of SpO 2?PONV and visceral stretch reflexion were observed and compared during the operations.Results The same dose of innovar can relieve the PONV remarkably by making use of the two methods and SpO 2 was reduced considerably in group I.The effects of repressing the visceral stretch reflexion were almost the same.Conclusion Epidural innovar can be functioning in central nervous by way of permeating through the cerebrospinal fluid moderately and permanently.The effect of epidural innovar is acceptable during lower abdominal operation.