晶体液和胶体液预负荷预防硬膜外阻滞复合全麻诱导期低血压效应的研究  

Effect of volume preloading to prevent hypotension associated with epidural block combined general anesthesia

作　　者：田玉红[1] 彭章龙[2] 

机构地区：[1]秦皇岛市第二医院麻醉科,河北省秦皇岛066600 [2]上海第二医科大学附属瑞金医院麻醉科

出　　处：《中国基层医药》2006年第5期709-711,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：河北省2004年科学技术研究与发展指导计划基金资助项目(04276120)

摘　　要：目的比较晶体液和胶体液预负荷预防胸段硬膜外阻滞复合全麻诱导期低血压效应.方法ASA Ⅰ～Ⅱ级择期行上腹部手术患者90例,随机分为三组,每组30例.A、B和C三组分别以1000 ml复方乳酸钠注射液、500ml和1000 ml聚明胶肽溶液在40 min进行容量预负荷,在预负荷过程中,经T8～9行硬膜外穿刺置管,用1.6%利多卡因和0.2%丁卡因混合液进行硬膜外阻滞,预负荷结束后开始全麻诱导.结果硬膜外阻滞、全麻诱导后及气管插管后,A和B组血压显著低于C组,A、B和C组低血压的发生率分别为70%、57%和23%,C组显著低于A、B两组.结论胶体液容量预负荷预防胸段硬膜外阻滞复合全麻后低血压的效应优于等量的晶体液.Objective To compare the effects of volume preloading with crystalloid and colloid fluid to prevent hypotension associated with thoracic epidural block combined general anesthesia. Methods Ninety ASA Ⅰ-Ⅱ grade patients, scheduled for elective upper abdominal surgery, were randomly allocated to three groups（ 30 patients in each group）. A,B and C group respectively received 1000ml lactated Ringer＇s solution,500ml and 1000ml polygeline injection for volume prelosding in 40min before general anesthesia induction. During volume prelosding, epidural catheter was placed at T8- 9 and blocked with mixed solution of 1.6 % lidocaine and 0.2 % dicaine. Results Systolic blood pressure（SBP） and diastolic blood pressure（DBP） were significantly lower in group A and B than those in group C after epidural block, general anesthesia induction and inrubation（ P 〈 0.05 ）. The incidence of hypotension was 70% ,57% and 23% for A,B and C group,respectively. Conclusion Colloid fluid is much better than crystalloid fluid for volume preloading to prevent hypotension associated with epidural block combined general anesthesia.

关 键 词：容量预负荷 麻醉 低血压 血流动力学 

分 类 号：R614[医药卫生—麻醉学]