全麻联合针刺在老年腹部手术中的应用  

General Anesthesia Combined with Acupuncture in Abdominal Surgery for Elderly Patients

作　　者：宫丽荣[1] 余剑波[1] 曹新顺[1] 王曼[1] 董树安[1] 张圆[1] 

机构地区：[1]天津市南开医院麻醉科,天津300100

出　　处：《中国中西医结合外科杂志》2013年第6期650-652,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:观察全麻联合针刺对老年腹部手术中血流动力学、应激反应及全麻药用量的影响。方法:80例择期行腹部手术老年患者随机分为全麻组(A组)和全麻联合针刺组(B组),B组全麻诱导前先行针刺诱导,连续监测血流动力学变化,检测麻醉前、切皮后和术毕血清皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)和血糖(Glu)浓度。结果:A组气管插管后1 min、切皮时、拔管毕的HR、MAP显著高于B组(P<0.05),切皮后及术毕B组血清Cor、NE、E及Glu浓度明显降低(P<0.05),B组术中丙泊酚、芬太尼用量减少,睁眼时间、完成指令时间、定位功能恢复时间缩短,术后躁动发生率低(P<0.05)。结论:全麻联合针刺应用于老年患者腹部手术可使血流动力学稳定、应激反应降低、全麻药用量及术后躁动例数减少。Objective To evaluate the efficacy of general anesthesia combined with acupuncture in abdomi- nal surgery for the elderly patients. Methods Eighty elderly patients undergoing abdominal surgery were ran- domly divided into group A （n=40） receiving general anesthesia and group B（n=40）receiving general anesthesia combined with acupuncture. In group B, the acupuncture points were punctured by twisting manipulations. Hae- modynamics were monitored, while the plasma levels of cortisone（Cor）, norephedrine（NE）, ephedrine（E） and glu- cose（Glu） were measured before anesthesia and at the end of surgery respectively. Results The plasma levels of Cor, NE , E and Glu were significantly higher in group A than those in group B in postoperation （P 〈 0.05）, while postoperative restlessness and general anesthesia dosage were lower in group B than those in group A（P 〈 0.05）. Conclusion Combined acupuncture assisted general anesthesia could stabilize the hemodynamics, re- duce the stress to the surgery in elderly patients undergoing abdominal surgery, thus being suitable and favor- able for these patients.

关 键 词：针刺 老年 全麻 腹部手术 

分 类 号：R614.2[医药卫生—麻醉学]