全麻和硬膜外阻滞下俯卧位行脊柱手术时血流动力学改变的比较观察

采用无创性连续心排血量监测仪（ＢＯＭＥＤＮＣＣＯＭ＿３），选择３０例腰椎间盘突出症患者，分为全麻组和硬膜外阻滞组。分别在麻醉和手术前后仰卧和俯卧体位时对血流动力学变化进行了监测，目的在于比较两种麻醉方法在俯卧位手术时对人体循环功能的影响，以选择合理的麻醉方法，提高麻醉和手术的安全。结果发现：（１）全麻下俯卧位手术对人体循环影响轻微；（２）硬膜外阻滞下平面达Ｔ＿（６～８）～Ｓ时，仰卧位时循环系统各项参数无明显变化，改俯卧位时发现心输出量（ＣａｒｄｉａｃＯｕｔ－ｐｕｔ，ＣＯ）等６项循环系统参数均有明显变化。

The Effect of Spine Operation in Prone Position on the Hemodynamic ChangesDuring Intravenous Anesthesia and Epidural Blockade

We devided 30 cases of prolapsed lum-bar intervertebral disc into intravenous and epiduralanesthesia groups to observe by continuous noninva-sive cardiac output monitor(BOMEDNCCOM_3).Before and after anesthesia and operation ,we moni-tored the hemodynamic changes between supine andprone position in order to choose an appropriate anes-thesic method and to enhance the safety of anesthesi-a. The results are following:1.The effect on hemo-dynamic was lighter during operation in prone posi-tion by intravenous anesthesia. 2.With the anesthe-sia level at T_(6～8)～S during epidural blockade, all theparameters about circulation in supine position hadno obvious change, but while changing into prone po-sition, six circulation parameters such as CO, CI,SVall changed remarkably.It showed that the circula-tion volume decreased significently.Therefore,wesuppose that intravenous anesthesia is appropriate forspine operation in prone position and the epiduralanesthesia should be chosen cautiously according toits indication.