不同浓度罗派卡因硬膜外阻滞复合全麻时心率变异性的变化分析

目的　心率变异性 (HRV)分析判断麻醉深度 ,比较几种浓度的罗哌卡因行硬膜外阻滞 (EA)复合全身麻醉 (全麻 )时麻醉深度及循环功能稳定性 ,找出最佳者。方法　择期上腹部手术病人 80例 ,随机分为四组 :Ⅰ组为对照组 ,Ⅱ组用 0 .2 5 %、Ⅲ组用 0 .375 %、Ⅳ组用 0 .5 %的罗哌卡因复合全麻。全麻用药品种统一 ,用量根据HRV变化调节 ;记录强刺激时HRV各参数、平均动脉压 (MAP )、心率 (HR)的变化 ;术后统计各药总用量、输液量及手术历时 ,数据用PEMS软件处理。结果　Ⅲ组手术过程中HRV各参数及MAP、HR稳定 ,Ⅰ、Ⅱ组波动明显 (P <0 .0 5 ) ,Ⅳ组各参数虽然稳定 ,但是循环波动大 ,易出现低血压。结论　 0 .375 %的罗派卡因复合浅全麻过程平稳 ,循环功能稳定

Analysis the transformation of heart rate variability during combined general-epidural anesthesia

Objective To study the effects of combined general-epidural anesthesia with different concentration of ropivacaine on the anesthesia depth and stability of circulatory function by analyzing heart rate variability (HRV).Methods Eighty adult patients for selective abdominal surgery were randomly divided into 4 groups with 20 cases each. Combined general-epidural anesthesia was used in group II,III and IV, and general anesthesia alone in group I. Repivacaine 0.25% was given in group II, 0.375% in group III and 0.5% in group IV. Changed the anesthesia depth according to HRV.The parameters of HRV, heart rate (HR), mean arterial pressure (MAP) were measured at violent stimulations during surgery.Results MAP,HR and HRV were more stable in group III than others, and markedly changed in group I and group II (P<0.05). The parameters of HRV were more steady than circulatory function in group IV. But blood pressure was easily descended.Conclusion Combined general-epidural anesthesia with ropivacaine 0.375% can provide satisfactory anesthetic potency and maintain the stability of circulation function.