异丙酚辅助上腹部手术硬膜外神经阻滞的临床观察

目的 观察比较异丙酚和哌替啶、氟哌啶辅助上腹部手术的临床效果。方法 选择46例ASAⅠ -Ⅱ级行上腹部手术患者 ,随机分为异丙酚组 (Ⅰ组 )与哌、氟组 (Ⅱ组 ) ,每组23例。硬膜外阻滞选T8 -10,阻滞平面控制在T3 -4 阻滞平面稳定后 ,Ⅰ组静注负荷量异丙酚0.75mg/kg,5min后微泵持续输注2mg·kg-1·h -1 ,Ⅱ组静注哌替啶50mg,氟哌啶2.5mg。观察记录注药前后各时点参数值及不良反应、术中感受。结果 Ⅰ组注药后5minSpO2 明显下降 (p<0.05) ,Ⅱ组注药后10min ,20minSpO2 明显下降 (p<0.05)。VAS评分Ⅰ组(90 % )明显高于Ⅱ组 (30 % ) (p<0.05)。Ⅰ组不良反应发生率明显降低。结论 异丙酚辅助硬膜外神经阻滞行上腹部手术安全可行 ,优于哌、氟合剂。

Observation of propofol as an adjuvant during epidural blockade in upper abdominal surgery

Objective To observe the effect of propofol as an adjuvant during epidural blockade in upper abdominal surgery. Methods 46 ASA Ⅰ ～ Ⅱ patients undergoing upper abdominal surgery were allocated randomly into group Ⅰ (propofol group) or group Ⅱ (50mg pethidine and 2.5mg droperidol). Results A significant decrease of SpO2 was observed 5 min after a bolus of propofol in group Ⅰ and 10～ 20 min after pethidine and droperidol were given in group Ⅱ . The VAS>7― 8 reached 90％ in group Ⅰ , but only 30％ in group Ⅱ . Conclusion As an adjuvant of epidural blockade, propofol was safe and better than pethidine and droperidol mixture.