药物降压配合腰麻-硬膜外联合阻滞麻醉用于主动脉腔内隔绝术  

Analysis of endovascular graft exclusion undergoing combined spinal-epidural anesthesia with controlled hypotension

作　　者：陈万成[1,2] 刁玉刚[1] 刘晓江[1] 张铁铮[1] 王凤学[1] 荆全民[3] 

机构地区：[1]沈阳军区总医院麻醉科,沈阳110016 [2]阜新市第五人民医院麻醉科 [3]沈阳军区总医院心血管内科,沈阳110016

出　　处：《实用药物与临床》2009年第2期89-91,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨药物降压配合腰麻-硬膜外联合阻滞麻醉应用于主动脉腔内隔绝术(EVGE)的可行性。方法对我院70例Stanford B型夹层动脉瘤患者采用药物降压配合腰麻-硬膜外联合阻滞麻醉,回顾性分析其临床监测指标。结果全部患者在腰麻-硬膜外联合阻滞麻醉下顺利完成手术,除1例在ICU中因动脉瘤体内压较高致瘤体破裂而死亡外,余皆存活。全组患者血压控制满意,未出现严重心律失常,亦无麻醉意外发生。术后无硬膜外血肿等椎管内麻醉并发症。结论严格控制阻滞平面和血压,腰麻-硬膜外联合阻滞麻醉用于EVGE安全可行。Objective To approach the feasibility of combined spinal-epidural anesthesia （CSEA） with con- trolled hypotension adopted in endovascular graft exclusion （EVGE）. Methods 70 cases of Stanford B typed dissecting aneurysm undergoing CSEA were analyzed retrospectively. Results Operations were completed successfully under CSEA. All the patients survived except one patient（died of aneurysm rupture in ICU）. The blood pressure was controlled smoothly, no serious cardiac arrhythmias was observed, and no anesthetic accident happened. There was no epidural hematoma and the other complications of epidural anesthesia after operations. Conclusion CSEA is safe and feasible in EVGE when the blocked-limit and blood pressure were controlled carefully.

关 键 词：控制性降压 腰麻-硬膜外联合阻滞麻醉 主动脉腔内隔绝术 

分 类 号：R614[医药卫生—麻醉学]