全凭静脉联合胸段硬膜外阻滞麻醉在胸腔镜手术中的应用 |
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引用本文: | 熊国强,王英姿,覃军,杨军良.全凭静脉联合胸段硬膜外阻滞麻醉在胸腔镜手术中的应用[J].医药世界,2009,11(7):299-301. |
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作者姓名: | 熊国强 王英姿 覃军 杨军良 |
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作者单位: | 广东省深圳市龙岗中心医院麻醉科518116
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摘 要: | 目的:探讨全凭静脉全麻联合胸段硬膜外阻滞方法在胸腔镜手术中的应用。方法:择期胸腔镜微创手术术中需单肺通气的患者196例,ASAⅠ-Ⅱ级,随机分为A、B两组:A组选择98例患者入室后先做T56椎间隙硬膜外腔穿刺,向上置管34cm;B组采用全凭静脉全麻。两组病例全麻诱导后用传统方法插入双腔支气管导管(doublelumen endobronciltube,DLT),用纤维支气管镜(FOB)确定和调整导管的位置,术中采用全凭静脉全麻,记录生命体征等。结果:A组整个麻醉手术中血流动力学稳定,苏醒无痛,术后肺部并发症少,全凭静脉全麻联合硬膜外阻滞利于胸腔镜手术的开展。FOB检查能准确定位DLT位置。结论:胸腔镜手术中应用FOB检查定位DLT位置是单肺通气能否顺利进行的关键,全凭静脉全麻联合硬膜外阻滞一种安全有效的麻醉方法,合理应用更有利于胸腔镜手术患者的肺功能恢复。
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关 键 词: | 胸腔镜检查 麻醉 静脉 硬膜外 人类 |
To Investigate the Method of Combined Total Intravenous Anesthesia and Thoracic Epidural Anesthesia in Video-assisted Thoracoscopic Surgery |
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Institution: | XIONG Guo-qiang,WANG Ying-zi ,QIN Jun,et al. (Department of Anesthesiology,the Ninth People's Hospital of Shenzhen ,Shenzhen 518116 ,China) |
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Abstract: | Objective:To investigate the method of combined total intravenous anesthesia and thoracic epidural anesthesia in video-assisted thoracoscopic surgery.Method:To selecte minimally invasive video-assisted thoracoscopic surgery during one-lung ventilation to be 196 cases of patients,ASAⅠ~Ⅱ grade,were randomly divided into A,B group,A group of 98 cases of patients who choose to do after the break-T5~6 vertebral epidural space cavity puncture,catheter upward 3~4 cm.Group B total intravenous anesthesia.Two groups of patients after anesthesia induction using traditional methods to insert double-lumen endobronchial tube(double-lumen endobronciltube,DLT),using fiberoptic bronchoscopy(FOB)to determine and adjust the catheter position during the use of total intravenous anesthesia,recording vital signs and so on.Results:A group of results in the entire anesthesia hemodynamic stability,and to wake up pain-free,less postoperative pulmonary complications,total intravenous anesthesia combined with epidural block in favor of the development of video-assisted thoracoscopic surgery.FOB check DLT accurate location positioning.Conclusion:Application of video-assisted thoracoscopic surgery DLT positioning FOB check the location of one-lung ventilation is the key to success,total intravenous anesthesia combined with epidural block anesthesia a safe and effective way to more rational use of video-assisted thoracoscopic surgery patients to restore lung function. |
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Keywords: | Thoracoscopy Anesthesia Intravenous Epidural Humans |
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