全麻复合硬膜外阻滞在胸腔手术中的应用

目的:观察全麻复合硬膜外阻滞用于胸腔手术的临床效果。方法:90例择期行胸腔手术患者ASAⅠⅡ级,随机分为单纯全麻组(GA组)和全麻复合硬膜外阻滞组(GEA组),每组45例。两组全麻诱导和维持方法相同。GEA组于诱导前取T7～8椎间隙行硬膜外穿刺置管,注入2%利多卡因5ml,测定麻醉平面后给追加量。GEA组术毕行硬膜外镇痛。观察术中全麻药用量,苏醒、躁动和催醒例数,血液动力学、肺功能、术后疼痛和肺部并发症的情况。结果:GEA组较GA组全麻药用量少,苏醒快,躁动和催醒例数少,血压较GA组明显低,HR也相对较慢(P<0.05)。肺功能无显著性差异(P>0.05),GEA组术后无明显疼痛及出现肺部并发症。结论:全麻复合硬膜外阻滞用于胸腔手术病人可减轻应激反应,循环状态稳定,是安全可行的麻醉方法。

Application of General Anesthesthesia Combined with Epidural Block Anesthesia in Thoracic Operation

Objective:To observe the effects of general anesthesia (GA) combined with epidural block anesthesia in thoracic operation. Methods: Ninety patients with ASA I~II receiving thoracic operation were divided into general anesthesia group (GA n=45) and general anesthesia combined with epidural block anesthesia (GEA n=45 ) group.The method of general anesthesia was the same in two groups .The patients in GEA received the epidural puncture in T 7~8 and were injected 2% lidocaine 5 ml through the puncture,then given the additional amount after examining the level of anesthesia. At the same time,the patients in GEA received epidural analgesia.The usage of drug for general anesthesia ,cases of awake , restless and inducing awake ,hemodynomiss,pulmonary function,postoperative pain and pulmonary complication were observed in the two groups. Results: The dosage of drug for general anesthesia and the cases of awake ,restless and inducing awake lower in GEA than in GA (P<0.05).There was no significant difference for pulmonary function between two groups (P>0.05) . Conclusion :General anesthesia combined with epidural block anesthesia is a safe and feasible anesthesia method for patients with thoracic operation .