控制性单侧硬膜外麻醉在乳腺癌改良根治术中的应用研究  

Study of Restraining Unilateral Epidural Anesthesia During Improving Radical Operation of Mastocarcinoma

作　　者：邱建磊[1] 王尔民[1] 赵煜毅[1] 

机构地区：[1]德州市人民医院麻醉科,山东德州253014

出　　处：《医学综述》2010年第5期777-779,共3页Medical Recapitulate

摘　　要：目的观察控制性单侧硬膜外麻醉在乳腺癌改良根治术中的应用效果。方法选择女性乳腺癌改良根治术患者100例,随机分为试验组和对照组,每组各50例,试验组取患侧在下的侧卧位,于T3～4间隙正中入路行硬膜外腔穿刺,穿刺成功后向头端并偏向患侧30°置入硬膜外导管4cm,保持患侧在下的体位推注1%利多卡因+0.375%罗哌卡因混合液,药物固定15min后改为仰卧位。对照组则采用常规中向置管、仰卧体位后注药的方法。评测患侧神经阻滞数量、麻醉效果,并记录术中辅助用药及不良反应情况。结果试验组患侧神经阻滞数量多于对照组、麻醉优良率高于对照组,差异有统计学意义(P<0.05);对照组清扫腋窝淋巴组织及术终时段心率、呼吸频率加快,潮气量加大,动脉血氧饱和度下降明显,与试验组比较,差异均有统计学意义(P<0.05)。结论控制性单侧硬膜外麻醉在乳癌改良根治术中应用效果良好,并发症少。Objective To study the effect of restraining unilateral epidural anesthesia during improving radical operation of mastocarcinoma.Methods 100 woman adult patients for improving radical operation of mastocarcinoma were randomly divided into experimental group（group E,n=50）and control group（group C,n=50）.In group E,epidural puncture from midline was conducted at T3～4 interspace in lateral position with the affected side down,and an epidural catheter was placed into the epidural space for 4 cm beyond the needle tip lean to the affected side for 30 angles.Remaining the position,a test of lidocaine and continuous dose of 0.375% ropivacaine was injected through the catheter in turn,and then turned to dorsal position 15 mins later.But routine epidural puncture and catheter placement was produced in group C.Evaluating the number of blockade nerves of the affected side and anesthesia effect,recording complications after adjuvant.Results The number of blockade nerves of the affected side in group E were more than in group C（P 0.05）; anesthesia effect was much better in group E（P 0.05）;comparing with group E,the heart rates,the respiratory rates and tidal volumes were increasing,but pulse oxygen saturation was declining,all the differences were significant（P 0.05）.Conclusion Restraining unilateral epidural anesthesia during improving radical operation of mastocarcinoma has better anesthesia effect and less complications.

关 键 词：硬膜外麻醉 单侧 控制性 罗哌卡因 乳腺癌根治术 改良 

分 类 号：R614.42[医药卫生—麻醉学] R737.9[医药卫生—外科学]