老年上腹部手术七氟醚吸入全麻联合硬膜外阻滞的效果评价

目的探讨七氟醚吸入全麻联合硬膜外阻滞在老年人上腹部手术的麻醉效果。方法40例择期上腹部手术的老年患者,ASAⅡ～Ⅲ级。随机分为二组(n=40):七氟醚全麻联合硬膜外阻滞组(A组),异氟醚全麻联合硬膜外阻滞组(B组)。分别监测记录术前(T0)、切皮时(T1)、手术探查时(T2)、术毕时(T3)、拔管时(T4)、拔管后10min(T5)的血流动力学(MAP、HR)变化及两组停药至睁眼时间、拔管时间、说话时间等麻醉恢复指标和苏醒期躁动、术中知晓情况。结果两组血流动力学比较无统计学的显著差异(p>0.05),但A组易于控制BIS(脑电双频指数)值。A组睁眼时间、拔管时间、说话时间比B组明显缩短(p<0.01)且两组均无苏醒期躁动及术中知晓。结论七氟醚吸入全麻联合硬膜外阻滞在老年人上腹部手术的麻醉效果确切、平稳,苏醒迅速,是较为安全、理想的麻醉方式。

ANAESTHESIA EFFECT OF SEVOFLUR INHALATION ANESTHESIA COMBINED WITH EPIDURAL ANESTHESIA IN THE ELDERLY EPIGASTRIUM SURGERY

Objective To explore the anesthesia effect of Sevoflurane Inhalation Anesthesia Combined with Epidural Anesthesia in the Elderly Epigastrium Surgery. Methods 40 cases of elderly patients, who received selective Epigastrium operation, were randomized into two groups （n = 40 ） ：the Sevoflurane inhalation anesthesia combined with epidural group （A group ） and the lsoflurane inhalation anesthesia combined with epidural anesthesia group （B group）. Monitored and recorded the two groups＇ haemodynamics （MAP, HR） change at preoperative（ T0 ） ,the time that the skin exciding（ T1 ） ,the operations researching（ T2 ）, the end of the operations（ T3 ）, cannula removing（ T4 ）, and 10 min after cannula removing, respectively. And, during palinesthesia time from stopping medication to the time that the patient opening eyes, cannula removing, talking, etc. monitored and recorded the two groups＇ palinesthesia index,the restlessness,and the operation awareness,respectively. Results Comparing the two groups,it was short of statistic significance （p 〉0.05） ,but the A group was easy to control the BIS value. The time that the patient opening eyes, cannula removing, talking was shorter obviously than the B group. All patients of the two groups hadn＇ t palinesthcsia restlessness and operation awareness. Conclusion Sevoflurane inhalation anesthesia combined with epidural anesthesia in the elderly Epigastrium surgery was safe and perfect because its effect was doubtless and stabile, and the palinesthesia was rapid.