全麻复合硬膜外阻滞对血液动力学的影响

目的 观察浅全麻复合硬膜外阻滞对血液动力学的影响。方法 随机将２１例择期行腹腔镜胆囊切除手术病人分为全身麻醉组（ＧＡ组，１１例）和浅全麻复合硬膜外阻滞组（ＧＡ＋ＥＡ组，１０例），采用Ｓｗａｎ－Ｇａｎｚ导管技术，分别监测ＧＡ组吸入０．６ＭＡＣ、１．０ＭＡＣ安氟醚与ＧＡ＋ＥＡ组吸入０．６ＭＡＣ安氟醚基础上硬膜外注入２％利多卡因７ｍｌ前后血液动力学的变化。结果 两组吸入０．６ＭＡＣ安氟醚，ＭＡＰ均显著下

Effects of combination of general and epidural anesthesia on hemodynamics

Objective To observe the influences of combined general and epidural anesthesia on hemodynamics.Methods Twenty one patients were randomly divided into two groups, general anesthesia (GA group, n=11) and combined general and epidural anesthesia (GA EA group, n=10). With Swan Ganz technique, hemodynamic parameters were measured 5min following 0.6 and 1.0 MAC enflurane inhalation in GA group, and 5min following 0.6 MAC enflurane inhalation and 10min after combined epidural lidocaine in GA EA group.Results Compared with the baselines, in both groups with 0.6 MAC enflurane inhalation, MAP decreased significantly (P<0.05), HR, systemic vascular resistance (SVR), stroke index (SI), cardiac index (CI) changed unsignificantly(P>0.05); in GA group with 1.0 MAC enflurane inhalation, MAP, HR, SVR, SI and CI decreased significantly (P<0.05), in GA EA group with combined epidural anesthesia, MAP and SVR markedly reduced(P<0.01), but CI and SI remained stable (P>0.05). As compared with those following 0.6 MAC enflurane inhalation, only in GA EA group MAP and SVR decreased, and SI rose obviously (P<0.05) after combined epidural anesthesia.Conclusions Combination of mild general and epidural anesthesia is applied better, but the supplement of the blood volume or the administration with vascular active drugs should be noticed in order to reduce the fluctuation of hemodynamics.