上腹部手术患者中硬膜外阻滞复合浅全身麻醉的应用效果分析

Application of Epidural Block Combined with Shallow General Anesthesia in Patients Undergoing Upper Abdominal Surgery

目的探讨上腹部手术患者中硬膜外阻滞复合浅全身麻醉的应用效果。方法选取本院于2018年4月至2019年4月收治的76例行上腹部手术患者,依据随机数字表法分成2组,每组38例,对照组单纯行全身麻醉,观察组则行硬膜外阻滞复合浅全身麻醉,对比两组麻醉效果及全麻药用量情况。结果两组术中、后都没有出现呕吐、恶心情况。观察组术毕均清醒拔管,且安全达病房;而对照组需等待15 min后方能拔管。观察组躁动(2.63%)低于对照组(13.16%,P<0.05)。观察组术毕心率(HR)较对照组,明显偏低(P<0.05);观察组术中HR相比对照组,有显著降低(P<0.05)。对照组切皮后10 min、术毕相比麻醉前,均有明显升高(P<0.05),而观察组没有显著变化且较对照组偏低(P<0.05)。观察组术中维库溴铵、芬太尼用量较对照组偏少(P<0.05),而咪唑安定用量较对照组偏多(P<0.05),安氟醚吸入浓度低于对照组(P<0.05)。结论针对上腹部手术患者,通过实施硬膜外阻滞复合浅全麻,效果好。

Objective To investigate the effect of epidural block combined with superfi cial general anesthesia in upper abdominal surgery.Methods Sixtysix patients who underwent upper abdominal surgery in our hospital from April 20 to April 2019 were enrolled in this study.They were divided into two groups according to the random number table,38 cases in each group.The control group underwent general anesthesia alone,while the observation group performed hard.Extracorporeal block was combined with general anesthesia,and the anesthetic effect and the amount of general anesthesia were compared between the two groups.Results There was no vomiting or nausea in the two groups.The observation group was awake and bronched,and the safety was up to the ward;while the control group had to wait 15 minutes before extubation.The observation group was agitated(2.63%)lower than the control group(13.16%,P<0.05).The HR of the observation group was signifi cantly lower than that of the control group(P<0.05).The HR of the observation group was signifi cantly lower than that of the control group(P<0.05).The control group was signifi cantly increased 10 min after the incision and before the anesthesia compared with the anesthesia(P<0.05),but there was no signifi cant change in the observation group and lower than the control group(P<0.05).In the observation group,the dosage of vecuronium bromide and fentanyl was less than that of the control group(P<0.05),while the dose of midazolam was more than that of the control group(P<0.05),and the inhalation concentration of enfl urane was lower than that of the control group(P<0.05).Conclusion For patients with upper abdominal surgery,the effect of epidural block combined with shallow general anesthesia is good.