七氟醚麻醉加硬膜外阻滞对开胸手术儿茶酚胺及循环功能的影响

探讨七氟醚麻醉加胸段硬膜外阻滞对开胸手术儿茶酚胺及循环功能的影响。选择２４例择期开胸手术ＡＳＡ１～２ 级患者，随机分为七氟醚吸入麻醉（Ａ 组），七氟醚麻醉加胸段硬膜外阻滞（Ｂ组） 。手术６０ｍｉｎ 和气管拔管后１０ｍｉｎ 时Ａ 组血浆去甲肾上腺素（ＮＥ）与麻醉前比均明显增高（Ｐ＜０－０５），Ｂ组无明显增高（ Ｐ＞ ０－０５），组间比较Ｂ组ＮＥ均低于Ａ组（Ｐ＞ ０－０５）。两组血浆肾上腺素（Ｅ） 与麻醉前比均无明显增高（ Ｐ＞ ０－０５）。手术３０ｍｉｎ 时Ｂ组ＭＡＰ比麻醉前明显降低（Ｐ＜０－０５）。认为七氟醚麻醉加硬膜外阻滞可减轻开胸手术所致的儿茶酚胺分泌增高，是开胸手术较理想的麻醉方法。

Effects of sevoflurane anesthesia plus thoracic epidural blockade on plasma catecholamine levels in thoracotomy

The effects of sevoflurane anesthesia plus thoracic epidural blockade was assessed on cate cholamine levels during thoracic surgery.Twenty four patients undergoing thoracotomy were randomized two groups:sevoflurane anesthesia(groupA, n =12),sevoflurane anesthesia plus thoracic epidural blockade with 0.375% bupivacaine(group B, n =12).The plasma NE and E levels were determined using modifications of fluorimetric assay.Results showed that the increase NE levels in group B during surgery were attenuated( P >0.05),while significantly increased in the group A at 60min after skin incision and 10min after extubation( P <0.05).The non significant increases of E levels in two groups during surgery( P >0.05).The increase catecholamine levels during thoracotomy were attenuated by sevoflurane anesthesia plus thoracic epidural blockade.