全麻复合硬膜外阻滞在十腹部手术中的应用

目的观察全麻复合硬膜外阻滞在上腹部手术中其血流动力学稳定性的探讨。方法选40例择期胃癌根治术或胆道探查术患者，随机分为Ⅰ组（采用硬膜外阻滞复合全麻）和Ⅱ组（采用静吸复合麻醉），每组20例。两组病人全麻的诱导、维持方法相同，Ⅰ组病人术中间断硬膜外追加利多卡因。观察麻醉、苏醒期间心率、血压的变化和苏醒期苏醒质量及并发症。结果Ⅰ组围麻醉期血流动力学明显较Ⅱ组平稳（P〈0．05），苏醒及清醒快，且并发症少。结论全麻复合硬膜外麻醉用于上腹部手术其血流动力学稳定性好、并发症少，是一种值得推广的麻醉方法。

General Anesthesia Combined with Epidural Anesthesia in Upper Abdominal Surgery

Objective Observation of general anesthesia combined with epidural anesthesia in upper abdominal surgery of its hemodynamic stability. Methods Selected 40 cases of elective surgery,or gastric cancer in patients with bile duct exploration were randomLy divided into Ⅰ group with epidural anesthesia; Ⅱ group were treated with inhalation anesthesia,20 patients in each group. Two groups of patients with general anesthesia induction. To maintain the same way, Ⅰ group of patients additional surgery in intermittent epidural lidocaine. Observation of anesthesia,wake up during the heart rate,blood pressure changes and recovery period awakening quality and complications. Results Group Ⅰ hemodynamics during anesthesia significantly more stable in group Ⅱ（P〈0.05）, wake up and awake faster,and fewer complications. Conclusion General anesthesia combined with epidural anesthesia for upper abdominal surgery of its hemodynamic stability,fewer complications,is a worthy extension of the anesthesia.