麻醉状态下乙醇对腹腔神经丛的毁损作用

目的探讨麻醉状态下乙醇对腹腔神经丛毁损的作用。方法选择36个择期行胰腺癌手术患者，aSaⅠ-Ⅲ，随机数字表法分为乙醇组与对照组，两组均给予丙泊酚（6—9mg·kg^-1·d^-1）和瑞芬太尼（O．1—0．3mg·kg^-1·min^-1）静脉麻醉，乙醇组对腹腔神经丛局部注射75％乙醇30ml；对照组局部注射0．9％氯化钠注射液30ml。分别记录注射前5min、注射后1min、5min、15min、25min、35min、45min的脑电双频谱指数值（BIS值）、平均动脉压（MAP）、心率（HR）。结果与注射前相比：对照组各时点的BIS值与血流动力学值无明显变化，乙醇组注射后15min至45min四个时点BIS值、MAP明显下降，与对照组相同时点比较差异均有统计学意义（P〈0．001）。结论在丙泊酚瑞芬太尼麻醉下，术中使用乙醇能加深麻醉镇静深度。

The damage effect of ethanol on the celiac in patients with anesthesia by propfol combined with remifentanil

Objective To investigate the effect of ethanol using by neurolytic celiac plexus block(NCPB)on the Bispectral index(BIS)during anaesthesia with propofol and remifentanil.Methods Thirty-six patients,ASA Ⅰ～Ⅲ,undergoing pancreatic cancer surgery were studied.Patients were maintained with propofol(6～9mg·kg～·h-1)and remifentanil(0.1～0.3μg·kg～·min-1)to keep the BIS between 38 and 50.After 30minutes of stable anesthesia,patients in control group were treated with NCPB by 0.9%NS 30ml,while patients in ethanol group were employed NCPB at the same time by 75%ethanol 30m1.BIS values,mean arterial pressure(MAP),heart rate(HR)were recorded 5minutes before the injection and one,five,fifteen,twenty five,thirty five,forty five minutes after that.Results Therewas no significant change in BIS,emodynamic variables compared to preinjection values in the control group.15min to 45min after injection of four point,BIS values and MAP of ethanol group decreased significantly,as compared with before injection,the same time point compared with the control group had statistically significant difference(P＜0.001).No significant changes in HR were observed throughout the observation.Conclusion Ethanol used in the operation of NCPB was additive to the anesthesia depth during the anesthesia of propofol and remifentanil.