不同剂量胸段硬膜外阻滞加七氟醚麻醉对开胸手术病人血流动力学的影响  

The Effect of Different Doses of Thoracic Epidural Blockage with Sevoflurane Anesthesia on Hemodynamics in thoracotomy

作　　者：李权义[1] 康华[1] 杨光[1] 

机构地区：[1]哈尔滨医科大学附属第三医院

出　　处：《黑龙江医学》2000年第4期6-8,共3页Heilongjiang Medical Journal

摘　　要：目的 :探讨不同剂量胸段硬膜外阻滞加七氟醚麻醉对开胸手术病人血流动力学的影响。方法 :根据胸段硬膜外腔注入 1 33%利多卡因 - 0 1 6 %地卡因混合液剂量的不同 ,随机将病人分为A、B、C、D　 4组 ,每组 1 0例。A组为对照组单纯七氟醚麻醉 ,B、C、D组硬膜外腔在诱导前 1 0min分别注入 5ml、1 0ml、1 5ml利地混合液。结果 :单纯七氟醚麻醉 (A组 )插管和拔管时血压明显高于麻醉前 (P <0 0 1 )和硬膜外组。术中血压平稳 ,但心率明显高于麻醉前 (P <0 0 1 )和硬膜外组 (P <0 0 1 )。硬膜外组在诱导后及术中心率保持平稳与麻醉前无明显差异 (P >0 0 5 )。结论 :对于开胸手术病人 ,施行硬膜外阻滞加七氟醚麻醉 ,硬膜外腔用药量不宜过多 ,5～ 1 0ml血液动力学较稳定。Objective:This trial was designed to study the effect of different doses of thoracic epidural blockage with sevoflurane anesthesia on hemodynamics in thoracotomy.Methods:According to different doses of lidocaine 1.22% with dicaine 0.16% used in thoracic epidural blockage,forty patients were randomly assigned to four groups.There were ten patients in each group.Group A as control group (sevoflurane anesthesia alone),group B.C.D received 5ml,10ml,15ml lidocaine 1.33% with dicaine 0.16% at ten minutes before induction respectively.The changes of hemodynamics were observed from induction to one hour after surgery.Results:In group A (sevoflurane alone,blood pressure between induction and extubation were higher than pre-anesthesia (p<0.01) and epidural group (group B.C.D).blood pressures were stable during the surgery,but heart rates were higher than pre-anesthesia (p<0.01) and epidural groups (p<0.01).there was no statistically difference in heart rate in epidural groups throughout the study(p>0.05).Conclusions:The epidural doses should be available from 5-10ml so that to obtain the stable hemodynamics in the combination of epidural blockage and sevoflurane during thoracotomy.

关 键 词：麻醉 七氟醚 病人 开胸手术 不同剂量 人血 胸段硬膜外阻滞 结论 中心 心率 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]