布比卡因对维吾尔族手术患者心肌酶谱的影响  

The influence of the bupivaine myocardial enzymes on upper abdomen operation of the minority

作　　者：闫相华[1] 卢安东[2] 张甲平[2] 冯杰[2] 

机构地区：[1]解放军第18医院医务处,新疆叶城844900 [2]解放军第18医院麻醉科,新疆叶城844900

出　　处：《中国基层医药》2005年第9期1145-1146,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察全麻硬膜外布比卡因复合麻醉对维吾尔族上腹部手术患者心肌酶谱的影响。方法随机将择期行上腹部手术维吾尔族患者30例分为两组(每组15例),均先行T8～9或T9～10间隙硬膜外穿刺并置管,成功后用芬太尼2μg/kg、维库溴铵0.1mg/kg、咪唑安定0.15mg/kg、异丙酚2mg/kg诱导行气管插管,用异氟醚吸入和异丙酚3mg·kg-1·h-1恒速输注维持麻醉。A组手术切皮前由硬膜外导管分次注入0.5%布比卡因1.8mg/kg,用量(17.0±3.2)ml[(82.5±12.6)mg];B组注入1.6%利多卡因、0.16%丁卡因合剂(16.0±4.6)ml。分别监测术前(T0)、全麻诱导后(T1)、插管后5min(T2)及术毕(T3)的血流动力学和心肌酶谱的变化。结果两组谷草转氨酶(GOT)和肌酸磷酸激酶(CPK)在术毕较对照值明显升高(P<0.05或P<0.01);A组乳酸脱氢酶(LDH)在插管后5min及术毕较B组明显升高(P<0.05或P<0.01),其余指标均在正常范围。结论全麻复合硬膜外布比卡因阻滞麻醉对行上腹部手术的维吾尔族患者的心肌酶无明显影响。Objective To observe the influence of myocardial enzymes at thoracic epidural anesthesia combined with general anesthesia on upper abdomen operation of the minority. Methods 30 patients of the minority undergoing upper abdomen operation were seperated into two groups at random （ 12 = 15）. Two groups were both induced with fentanyl 2μg/kg, vecuronium 0.1 mg/kg, midazolam 0.15mg/kg, propofol 2mg/kg after succeeding in puncturing putting and managing epidural at interval T8-9 or T9-10, keep anaesthetizing by isoflurane inhalation and propofol 3mg/kg iv constantly,poured local anesthetics into epidural before cut covers 0.5% bupivaine was poured into epidural with 1.8 mg/kg gradually in group A. the consumption was （ 17.0 ± 3.2 ） ml [ （ 82.5 ± 12.6 ）mg ] ; in group B the mixture of 1.6% lidocaine and 0.16% tetracaine was poured with （16.0 ± 4.6）ml. Monitoring the hemodynamics and myocardial enzymes before operation （T0）, after induction （ T1 ）＇, after inducing 5min （ T2 ） and when the operation finished（T3）. Results The GOT and CPK were higher than control group observably（P 〈 0.05 or P〈 0.01 ）, LDH in group A was higher observably than group B after inducing 5min and when the operation finished（P 〈 0.05 or P 〈 0.01 ）. Conclusion Thoracic epidural supivaine anesthesia combined with general anesthesia on upper abdomen operation of the minority is safe and viable.

关 键 词：麻醉 布比卡因 酶学 血流动力学 腹部手术患者 心肌酶谱 维吾尔族 布比卡因 全麻复合硬膜外 上腹部手术 硬膜外穿刺 气管插管 肌酸磷酸激酶 

分 类 号：R614[医药卫生—麻醉学]