硬膜外阻滞复合气管插管全麻用于食道癌根治手术的临床观察

CLINICAL OBSERVATION OF EPIDURAL BLOCK COMPOUNDING WITH GENERAL ANESTHESIA FOR RADICAL ESOPHOGEAL CANCER

目的 :观察硬膜外腔阻滞复合气管插管全麻用于食道癌根治手术的临床效果 ;方法 :40例食道癌根治手术病人 ,随机分为A、B两组 ,A组硬膜外腔阻滞复合气管插管全麻 ,B组单纯全麻。两组分别监测气管插管、切皮、术毕、气管拔管时的HR、MAP ,术毕苏醒时间 ,苏醒期躁动情况和麻醉维持期全麻用药量 ;结果 :HR、MAP变化A组较B组低且平稳 (P <0 .0 1 ) ;A组丙泊酚量 ( 2 .56± 0 .89)mg/ (kg·h)小于B组 ( 4.1 2±1 .51 )mg/ (kg·h) (P<0 .0 5) ;A组维库溴铵量 ( 3 .5± 1 .5)mg/ (kg·h)小于B组 ( 5.2± 1 .0 )mg/ (kg·h) ;A组清醒时间 ( 1 2 .1± 3 .2 )分钟较B组 ( 3 5.2± 1 2 .3 )分钟短 (P <0 .0 1 ) ;苏醒期躁动A组几乎无躁动 ,B组轻度、中度、重度躁动分别为 4例、1 1例、3例 ;结论

Objective:To observe the clinical effects of using epidural block compounding with general anesthesia under endotracheal intubation on radical operation of esophageal cancer;Methods:40 cases with esophageal cancer were divided randomly into two groups.The patients in group A were performed with epidural block compounding with general anesthesia; and group B were performed with simple general anesthesia.The HR and MAP were measured during endotracheal intubation,at skin incision, end of operation and decannulation period. And the analepsia time post operation, restless manifestation and the dosage of anesthetic agents were recorded.Results:The changes of HR and MAP in group A were lower than those in group B.The dosage of propofol in group A (2.56±0.89)mg/(kg·h) was lower than in group B (4.12±1.51)mg/(kg·h) (P<0.05);The dosage of Veikuxiuan in group A (3.5±1.5)mg/(kg·h) was lower than in group B (5.2±1.0)mg/(kg·h) (P<0.05);analepsia time in group A (12.1±3.2)min was shorter than in group B (35.2±12.3)min (P<0.05);No restless manifestation in group A, but there were light, medium and severe restless manifestation in the 4,11 and 3 cases respectively in group B.Conclusion:The epidural block compounding with general anesthesia is more available than the simple general anesthesia for radical operation of esophageal cancer.