硬膜外麻醉与全麻对老年人循环功能影响的对比——附309例分析

总结60岁以上老年患者胸_(10)以上硬膜外麻醉与气管内全麻309例临床资料,比较这两种麻醉方法对循环功能的影响。结果表明:两种麻醉方法血压、脉搏在全麻诱导和硬膜外麻醉注入首次总药量后5～15min 内变化最大。因此,力争此期麻醉平顺、循环功能稳定是保证病人手术安全的关键。硬膜外麻醉主要使血压下降或剧降;全麻主要使血压上升或剧升,但全麻较易维持循环功能稳定。因此,对老年循环功能代偿良好者,可慎重选用硬膜外麻醉,若欠佳者,则以气管内全麻为安全。

COMPARISON OF THE EFFECTS BETWEEN EPIDURAL AND GENERAL ANESTHESIA ON CIRCULATION FUNCTION IN SENILE PATIENTS

This paper presents the clinical data of 309 patients,aged 60-77,with ep- idural and general anesthesia respectively and compare their changes in blood pressure and pulse rate daring anesthesia.The epidural catheter was inserted via intervertebral space above T 10.The trachea intubation was perfomed after thiopental and succinycholine intravenously.The general anesthesias were maintained with ether or a continuous infusion of mixture of procaine,pet- hidine and relaxant.The results showed that the maximal changes of blood pre- ssure and pulse rate were presented in the induction peiriod of general anesth- esia and within 5-15 minutes of epidural administration of the first total dose of anesthetics.It is very important to obtain hemodynamic steadiness for safety of senile people during the initial period of anesthesia. In this study,the main characteristic was hypotension or severe hypotens- ion in most epidural anesthesia,In general anesthesia was hypertension or marked hypertension but it may easily maintain the circulatory funcfion ste- adily.These results lead to the conclusion that one may select epidural anes- thesia with care for a senile patient with good circulatory function,while patient has a poor circulatory function need general anesthesia through trachea intubation.