全麻硬膜外联合麻醉与食管癌根治术中的临床应用

Chinical application of combined general - epidural anesthesia during resection of esophageal carcinoma

目的:观察全麻联合硬膜外阻滞麻醉用于食管癌手术的可行性。方法:26例择期食道中或下段癌根治术病人随机分为两组:A组全麻联合硬膜外组;B组单纯全麻组。术中监测并记录麻醉前、插管后1min,切皮,手术2h和拔管即刻五个时间段的平均动脉压、心率及血糖改变。计算全麻用药量、拔管及完全苏醒时间。结果:A组血压、心率改变较为B组平稳(P<0.05),A组血糖在麻醉前后无明显变化,而B组则显著升高(P<0.01)。A组全麻用药量少(P<0.01),拔管及完全苏醒时间短(P<0.01)。结论:全麻联合硬外阻滞用于食管癌手术,具有麻醉平稳应激反应小,苏醒快等优点,是一种可行的麻醉方法。

Objective To evaluate the feasibility of Combined general - epidural anestheia during resection of middle or inferior esophageal Carcinoma. Methods Twenty - six patients undergoing esophagectomy ASA Ⅱ-Ⅲ, were idvided randomly into two groups, Combined general - epidural anesthesia was used in group A. and general alone in group b. ABP ., HR and Blood glucose were monitored and were recorded before anesthesia , at Ⅰ min after intubntion , skin incision , 2h during operation and soon after extubion . The general anesthetic dosage, the time of extubation and total awareness were recorede and measured. Results BP and HR were more stable in groupA(P<0.01). The time of extubation and total awareness was less in group A(P<0.01). Conclusion Combined general-epidural anesthesia Can cause more stable hemodynamics, faster recovery from anesthesia, less stress response and is an aevailable method during esophagectomy.