心脏病患者非心脏手术麻醉处理体会

目的　探讨在心脏病患者进行非心脏手术的麻醉处理中 ,选择硬膜外阻滞加全麻方法的合理性。方法　 18例美国麻醉学会麻醉术前评估 (ASA)Ⅱ～Ⅲ级择期手术患者 ,入室先行硬膜外穿刺 ,待麻醉平面稳定 ,且无脊麻征象后做全麻。手术后用镇痛泵镇痛 72h。结果　 18例患者在麻醉过程中 ,血压较基础值均有不同程度的降低 ,ST段无明显改变 ,心律失常有好转 ,无心绞痛发作 ,术后均痊愈出院。结论　硬膜外麻醉加全麻能有效抑制胸腹部手术引起的应激反应 ,是心脏病患者安全有效的麻醉方法。

The experience of anesthesia of non-heart surgery in patients with heart diseases

Objective To investigate the rationality of epidural anesthesia combined with general anesthesia for non heart surgery in patients with heart diseases.Methods First,epidural anesthesia was carried out in 18 patients with heart diseases,then gereral anesthesia was given to each patients after anesthesia area stabilized without spinal anesthesia sign.The anesthesia pump was applied to each patient for 72 hours after operation.Results During anesthesia,blood pressure decreased with a vary of degree compared with the basal value,EKG monitor showed ST segment unchanged and arrhythmia improved,no patient had angina attack.All patients got well and discharged.Conclusion Epidural anesthesia combined with general anesthesia can inhibit the stress response induced by thoraco abdominal surgery,which is a safety and effective anesthesia way for patients with heart diseases.