不同药物联合硬膜外麻醉对术中应激的影响

Effects of different drugs combined epidural anesthesia in the intraoperative stress

目的观察不同药物联合硬膜外麻醉对术中应激的影响。方法选取2016年2月~2017年1月在我院实施盆腔手术的患者64例为研究对象,将患者按随机抽签法分为对照组和研究组各32例,对照组使用咪达唑仑联合硬膜外麻醉方式,研究组使用芬太尼联合硬膜外麻醉方式,观察比较两种麻醉方式对患者术中应激反应的影响。结果对照组麻醉前5min时的血浆β-EP浓度和皮质醇浓度均低于麻醉后,研究组麻醉前5min时的血浆β-EP浓度和皮质醇浓度均高于麻醉后,两组患者的血浆β-EP浓度和皮质醇浓度在麻醉前后比较均存在明显差异性(P<0.05)。两组患者的血压和心率在麻醉前5min和麻醉后10min比较差异均无统计学意义(P>0.05)。结论术前给予小剂量镇痛剂联合硬膜外麻醉方式,能够使患者术中应激反应得到较好的控制,具有临床应用价值。

Objective To observe the effects of stress during the operation use different drugs combination with epidural anesthesia. Methods Selection 64 patients with pelvic surgery as the research object from February2016 to January 2016 in our hospital.According to the random draw method the patients were divided into control and research group each 32 cases.The control group was using midazolam combined epidural anesthesia,and the research group was using fentanyl combined epidural anesthesia.Compare the effects on stress reaction in patients with two kinds of anesthesia. Results TheβEP of the plasma concentration before 5 min anesthesia in the control group and cortisol concentrations were lower than after anesthesia,but were higher than after anesthesia in the research group.Comparative before and after anesthesia between two groups were differences（P〈0.05）.Compare differences of the blood pressure and the heart rate of patients with the 10 min after and the 5 min before anesthesia in two groups had no statistical significance（P〉0.05）. Conclusion By giving small doses of painkillers combined epidural anesthesia can make a better control of stress reaction in patients.