全麻复合硬膜外阻滞在高原高血压腹腔镜胆囊切除术中的应用  

Application of general anesthesia and epidural anesthesia on laparoscopic cholecystectomy for patients with hypertension at high altitude

作　　者：王育红[1] 王同猛 李宏文[1] 尚安云[1] 卫强[1] 

机构地区：[1]解放军第22医院麻醉科,青海格尔木816000

出　　处：《西部医学》2010年第1期95-97,共3页Medical Journal of West China

摘　　要：目的观察单纯全麻与全麻复合硬膜外麻醉用于高原地区高血压患者行LC对血流动力学的影响。方法40例高血压患者行LC,随机分成单纯全麻组(A组,20例)和全麻复合硬膜外组(B组,20例),监测气管插管后及气腹后血液动力学的变化,比较术中用药量和术毕苏醒情况。结果①气管插管及气腹后A组患者的收缩压,舒张压,心率明显上升,与B组相比存在明显差异(P<0.05)。②A组异丙酚与芬太尼的用量明显大于B组(P<0.05)。③A组术毕自主呼吸恢复时间、拔管时间与B组相比明显滞后,存在显著差异(P<0.05)。结论全麻复合硬膜外麻醉用于高血压患者施行LC,能明显减轻术中的应激反应,有利于维持血流动力学的稳定,且全麻用药量显著减少,术毕苏醒快,并发症少。Objective To observe the simple anesthesia and general anesthesia combined with epidural anesthesia for patients with hypertension at high altitude LC on hemodynamies. Methods 40 patients with hypertension with LC were randomly divided into A group （20 cases） treated with general anesthesia and B group treated with general anesthesia combined with epidural group （20 cases）. The parameters of hemodynamics, dosage of drug and awaking situation were observed. Results After tracheal intubation and pneumoperitoneum, systolic blood pressure, diastolic blood pressure and heart rate of A group significantly increased, compared with that of B group （P〈0.05）. The dosage of propofol and fentanyl of A group of was larger than that of B group （P〈0.05）. The duration to restoration of spontaneous breathing and extubation were longer than that of B group （P〈0. 05）. Conclusion The general anesthesia combined with epidural anesthesia for hypertension patients with LC can significantly reduce the stress response and decrease dosage of drugs.

关 键 词：高原地区 高血压 LC 全身麻醉 硬膜外麻醉 

分 类 号：R657.4[医药卫生—外科学]