罗呱卡因硬膜外阻滞后异丙酚靶控输注麻醉的临床观察

目的通过脑电双频指数的监测,评价罗呱卡因硬膜外用药后对异丙酚靶控输注（TCI）时麻醉剂量和质量的影响。方法 60例接受上腹部手术患者随机分为硬膜外罗呱卡因组（GR）和单纯异丙酚组（PR）二组。GR组硬膜外给药20min后,二组TCI输注异丙酚致意识消失,记录所需时间,继续全麻诱导观察插管反应。所有患者同时监测心电图（ECG）,血压（MAP）,及脑电双频指数（BIS）并记录异丙酚的效应室浓度（Ce）及用量。结果患者意识消失所需时间及异丙酚的效应室浓度、用量GR组与PR组有统计学显著差异。GR组MAP在硬膜外用药15min、意识消失时、插管后1min,与PR组相比较有显著性差异。结论罗呱卡因硬膜外阻滞可减少异丙酚靶控输注（TCI）时镇静催眠的用量,提高麻醉质量,并缩短意识消失所需的时间,并且有助于血流动力学的平稳,减轻插管反应。

Clinical study of tracheal intubation general anaesthesia with target controlled infusion of propofol after epidural ropivaeaine block

Objective To evaluate the effect of tracheal intubation general anaesthesia with target controlled infusion of propofol after epidural ropivaeaine block. Methods Sixty ASA Ⅰ～Ⅱpatients scheduled for upper abdominal surgery were randomly assigned into two groups：ropivaeaine group,（ groupGR,n = 30） and propofol alone group,（ group PR,n = 30）. Twenty minutes after epidural local anesthetics administration,a propofol target-controlled infusionwas started until one minute after tracheal intubation. The consumed time of patients losing consciousness,the target concentration and the consumed amount of propofol,BIS and MAP were all recorded in fixed time. Results The consumed time of losing conseiousness,the target coneentration and the consumed amount of propofol and MAP were all statistically significant difference between the GR group and PR group. GR group of MAP in the epidural medication 20 minutes,consciousness disappears,1 minute after intubation,compared with the PR group were significantly different. Conclusion Epidural ropivacaine block can enhance the sedative and hypnotic effect of propofol target-controlled infusion,and epidural ropivacaine block can improve the quality of anesthesia,And contribute to the smooth hemodynamic,reduce the intubation response.