罗哌卡因硬膜外复合全麻在开胸手术中的应用  

Application of ropivacaine epidural anesthesia combined general anesthesia in thoracic operation

作　　者：陈受业[1] 梁肇明[1] 石显江[1] 

机构地区：[1]广西医科大学第七附属医院麻醉科,广西梧州543001

出　　处：《华夏医学》2012年第4期559-561,共3页Acta Medicinae Sinica

摘　　要：目的:探讨0.375%罗哌卡因硬膜外阻滞复合全麻在开胸手术中的麻醉效果。方法:选择ASAⅠ～Ⅱ级择期肺癌或食道癌手术患者60例,随机均分成硬膜外阻滞复合全麻组(GEA组)和单纯全麻组(GA组),监测两组患者入室时(T0)、全麻诱导插管后(T1)、切皮时(T2)、手术探查时(T3)及术毕拔管时(T4)的MAP、HR,并记录各组丙泊酚、维库溴铵、芬太尼等全麻药用量及术后清醒和拔管时间。结果:GEA组全麻诱导插管后、切皮时、手术探查时及术毕拔管时的MAP、HR明显低于GA组,GEA组丙泊酚、芬太尼、维库溴铵用药量均显著少于GA组,术后清醒和拔管时间比GA组短。结论:0.375%罗哌卡因复合全麻不仅能减少全麻药用量,清醒快及拔管早,而且使手术过程中血流动力学更平稳。Objective： To investigate the safety and effect of epidural block with 0.375% ropivacaine combined with general anesthesia for thoracotomy.Methods： 60 cases with selective operation on lung cancer or esophageal cancer（ASA I-II） were randomly divided into GEA group（combined general-epidural anesthesia） and GA group（general anesthesia）.MAP and HR were detected prior to induction of anesthesia（T0）,immediately after intubation（T1）,after skin incision（T2）,during exploration（T3） and after extubation（T4）.And the dosage of propofol,vecuronium and fentanyl,the time of consciousness and tracheal extubation were recorded.Results： Compared with GA group,MAP and HR at T1~T4 significantly decreased in GEA group,the same as the dosage of general anesthesia drug and the time of consciousness and tracheal extubation.Conclusion： 0.375% ropivacaine combined with general anesthesia can not only reduce the anesthetic dosage,quick awakening and extubation early,but also maintain hemodynamics steadily during the entire anaesthesia surgery process.

关 键 词：开胸手术 罗哌卡因 硬膜外阻滞 全麻 

分 类 号：R656.61[医药卫生—外科学]