硬膜外复合吸入全麻用于肝叶切除3 858例总结

目的：考察硬膜外复合吸入全麻用于肝叶切除手术的优缺点，以探讨较为理想的肝脏手术麻醉方法。方法：比较硬膜外复合吸入全身麻醉（n=3858)，单纯硬膜外麻醉（n=100)及单纯全麻（n=100)患者行肝叶切除术中生命体征，麻醉药用量及术后苏醒情况的差异。结果：硬膜外复合全麻组在诱导期对心率，血压影响较大，但一定量的麻黄素即可纠正，该法可明显减少阿曲库铵，芬太尼及吸入麻醉药的用量，硬膜外复合全麻组早期清醒拔管，很少发生烦躁，术后较长时间内无切口痛，结论：持续硬膜外复合吸入全麻用于肝吸切除手术优于单纯硬膜外麻醉及单 纯全麻，是肝脏手术麻醉比较理想的方法。

General anesthesia combined with epidual block in 3 858 patients received hepatectomy

Objective:To investigate the advantages and disadvantages of general anesthesia combined with epidual block in patients undergoing hepatectomy. Methods:Patients were randomly divided into 3 groups:general combined with epidual ( n = 3 858), general anesthesia group ( n =100) and epidual block group( n =100). The life sign, dose of anesthetics, and postoperative awake were compared among the 3 groups. Results: General anesthesia combined with epidual block group influenced heart rate and blood pressure, ephedine could rectify this effect greatly. It also markedly reduced the dose of atracurium,fentanyl and inhaled anesthetics. General anesthesia combined with epidual block group awakened extube earlier without dysphoria and had a longer term pain relief effect than other groups. Conclusion:General anesthesia combined with epidual block is safe and reasonable for hepatectomy compared with general or epidual anesthesia alone.