低浓度硬膜外阻滞复合静脉全麻在妇科老年患者术中的临床观察

目的 观察低浓度硬膜外阻滞复合全麻在妇科老年患者手术中的应用,了解患者术中状态,术中静脉全麻药用量的区别,以及患者术毕恢复情况和术后不良反应的发生情况.方法 选取80例妇科腹腔镜辅助阴式子宫全切术的老年患者,随机分为2组,一组为低硬膜外阻滞复合静脉全麻组（A组）,另一组为全凭静脉麻醉组（B组）,A组于全麻诱导前行硬膜外穿刺,麻醉平面出现后,行全麻诱导插管,硬膜外麻醉平面控制在T6水平,B组直接进行静脉全麻.术中观察患者生命体征,记录全麻药及局麻药的使用情况.术毕记录患者不良反应发生情况及唤醒时间.结果 A组使用的全麻药丙泊酚,瑞芬太尼、维库溴铵药量显著低于B组,差异有统计学意义（P＜0.05）.A组术毕,不良反应的发生情况唤醒时间也显著低于B组,差异有统计学意义（P＜0.05）.结论 低浓度硬膜外阻滞复合全麻应用于妇科老年患者,操作简便安全,硬膜外镇痛良好,麻醉效果可靠,能显著减少老年患者在术中的静脉全麻药使用量,不良反应少,术后苏醒迅速彻底,较之全凭静脉麻醉具有更好的可行性和安全性

The clinical observation of low concentration epidural block combined with intravenous anesthesia used in gynecological elderly patients

Objective TO Observe the low concentration epidural block combined with intravenous anesthesia used in gynecological surgery of elderly patients, patients in state,the difference in the amount of intraoperative intravenous anesthetics, as well as the adverse reactions of patients with surgery recovery and postoperative.Methods Selecting 80 elderly patients with laparoscopic assisted vaginal hysterectomy, divided into two groups randomly, one group for low concentration epidural block combined with intravenous anesthesia （group A）, another group of general intravenous anesthesia group （group B）, group A epidural puncture before general anesthesia induction, general anesthesia induction intubation after anesthesia appears, the epidural anesthesia control at level T6, group B intravenous general anesthesia directly. Observing intraoperative patients＇ vital signs and recording the use of general anesthetics and local anesthetics. Record patients＇ occurrence of adverse reactions and wake-up time after surgery. Results The use of anesthetics propofol and remifentanil vecuronium that low concentration epidural block combined with general intravenous anesthesia （group A） uses are significantly lower than that in group B（general intravenous anesthesia）（P 〈0.05）.After group A surgery, group A＇ s occurrence of adverse reactions and wake-up time was also significantly lower than group B,（P〈0.05）. Conclusion Low concentration epidural block combined with intravenous anesthesia used in gynecological surgery of elderly patients is safe and easy to operate, good for epidural analgesia, anesthetic effect reliable, can significantly reduce the use of intravenous anesthetics of the elderly patients in the intraoperative, have fewer postoperative adverse reactions, patients wake up quickly and thoroughly, compared to general intravenous anesthesia, low concentration epidural block combined with intravenous anesthesia has better feasibility and safety.