针刺复合安氟醚吸入全麻食管癌切除临床研究总结

目的 :观察针刺复合安氟醚全麻下实施食管癌根治手术的临床应用效果。方法 :采用随机单盲方法将 1 2 0名食管癌患者随机分为A、B、C三组。A组 (n =40 ) :针刺复合安氟醚吸入全麻组 ;B组 (n =41 ) :电极板穴位刺激复合安氟醚吸入全麻组 ;C组 (n =3 9) :单纯安氟醚吸入全麻组(对照组 )。麻醉诱导三组均静注维库溴铵、芬太尼、异丙酚 ,剂量相同。三组术中均静注芬太尼(2 μg·kg- 1 ·hr- 1 )、维库溴铵 (0 .0 3mg·kg- 1 ·0 .5hr- 1 ) ,并根据麻醉需要吸入安氟醚适宜浓度维持麻醉和肌松。A、B两组同时开放电刺激仪。结果 :A、B两组麻醉Ⅰ级率各为 67.5 0 %、68.2 9% ,C组Ⅰ级率仅 2 8.2 1 % ,两者比较P <0 .0 0 1 ;麻醉全过程安氟醚平均浓度 (ETEnf)A、B两组分别为0 .5 5 %、0 .5 0 % ,C组为 0 .83 % ,A、B两组比C组吸入安氟醚浓度分别低 (少 ) 3 3 .73 %、3 9.76% ,P <0 .0 0 5。结论 :针刺复合安氟醚吸入全麻不但增强镇痛效果 ,而且减少安氟醚吸入用量 ,并突出了针麻优越性 ,可供临床选用。

Summary of Clinical Research on Acupuncture Anesthesia in Combination with General Anesthesia of Enflurane Inhalation for Resection of Esophageal Carcinoma

Objective: To observe the clinical effect of acupuncture anethesia in combination with general anesthesia of enflurane for radical operation of esophageal carcinoma. Methods:Single blind test has been adopted and 120 cases were divided at random into 3 groups, i.e. A, B, C. Group A (n=40): acupuncture integrated with general anesthesia of enflurane inhalation. Group B (n=41): acupoint stimulation with plate electrode combined with general anesthesia of enflurane inhalation. Group C (n=39): simple inhalation general anesthesia (control group). Acupoints used were Yifeng (TE 17), Sanyangluo (TE 8) to Ximen (PC 4) and Xiayifeng and were stimulated with electric current 2～ 4 mA, frequency 2/15 Hz and intermittent dense sparse waves in Group A. Sanyangluo (TE 8) and Xiayifeng were stimulated with 10～13 mA via skin electrodes. For anesthesia induction all the 3 groups received same dose of intravenous injection of vecuromine, fentanyl and isophorone. During the operation all the groups received intravenous injection of fentany (2 μg·kg -1 ·hr -1 ), and vecuromine (0.03 mg·kg -1 ·0.5 hr -1 ), and inhaled the enflurane of appropriate concentration to maintain anesthesia and muscular relaxation according to the requirements for anesthesia. In group A and Group B the electric stimulation were used at the same time.Results: In Group A and Group B the rate of anesthesia grade I is 67.50% and 68.29% respectively, whereas in group C the rate of Grade I is merely 28.21%,P<0.001; In the whole process of anesthesia the average concentration of enflurane in Group A and Group B was 0.55% and 0.50% respectively, but in Group C it was 0.83%. The inhaled enflurane concentration in Group A and Group B is 33.73% and 39.76% respectively being strikingly lower than that of Group C (P<0.005).Conclusion:Acupuncture combined with general anesthesia of enflurane inhalation can not only enhance the analgesic effect, but also reduce the inhalation dosage of enflurane, it reveals the advantage of acupuncture anesthesia, thus, being applicable in the clinic.