硬膜外麻醉复合气管插管全麻对自发性气胸患者术中血压心率及术后疼痛的影响  

Effect of epidural anesthesia combined with tracheal intubation for general anesthesia on intraoperative blood pressure,heart rate and postoperative pain in patients with spontaneous pneumothorax

作　　者：隋红阳[1] 娄安峰[1] Sui Hongyang;Lou Anfeng(First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450000

出　　处：《临床心身疾病杂志》2019年第6期28-31,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨硬膜外麻醉复合气管插管全麻对自发性气胸患者术中血压、心率变化及术后疼痛的影响.方法将240例自发性气胸患者按随机数字表法分为两组,各120例.两组均行闭式胸腔引流术治疗,对照组实施气管插管全麻,观察组实施硬膜外麻醉复合气管插管全麻.比较两组麻醉诱导时间、苏醒时间、拔管时间及不良反应发生情况,于诱导前、插管后1 min、切皮时、单肺通气30 min时、拔管时检测患者的心率、收缩压、舒张压、血氧饱和度变化,于术后2h、6h、12h、24 h采用视觉模拟评分法评定疼痛程度.结果观察组苏醒时间、拔管时间显著早于对照组(P<0.05或0.01),不良反应发生率显著低于对照组(P<0.05).插管后1 min、切皮时观察组心率、收缩压显著低于对照组(P<0.01);切皮时、单肺通气30 min时、拔管时,观察组舒张压显著低于对照组(P<0.0l),血氧饱和度显著高于对照组(P<0.01).术后2h、6h、12 h、24h观察组视觉模拟评分法评分均显著低于对照组(P<0.01).结论对自发性气胸患者实施硬膜外麻醉复合气管插管全麻,可减小患者术中血流动力学波动,减轻术后疼痛,加快患者苏醒,缩短拔管时间,安全性高.Objective To observe the effects of epidural anesthesia combined with tracheal intubation for general anesthesia on intraoperative blood pressure,heart rate and postoperative pain in patients with spontaneous pneumothorax.Methods A total of 240 patients with SP were divided into two groups according to the random number table,120 cases each.Both groups underwent closed thoracic drainage,the control group underwent general anesthesia with tracheal intubation,and the observation group underwent epidural anesthesia combined with tracheal intubation.Induction time,awakening time,extubation time,incidence of adverse reactions of the two groups were compared.Changes in heart rate,systolic blood pressure,diastolic blood pressure,and oxygen saturation were measured before induction,1 min after intubation,at the time of incision,30 min after single lung ventilation,and at the time of extubation.The degree of pain was assessed by visual analogue scale at 2 h,6 h,12 h,and 24 h after surgery.Results The recovery time and extubation time of the observation group were shorter than those of the control group(P<0.05 or 0.01),the incidence of adverse reactions was significantly lower than that of the control group(P<0.05).At 1 min after intubation,at the time of incision,the heart rate and systolic blood pressure of the observation group were significantly lower than those of the control group(P<0.01).At the time of incision,30 min after single lung ventilation,and at the time of extubation,the diastolic blood pressure of the observation group was significantly lower than that of the control group(P<0.01),and the oxygen saturation was significantly higher than that of the control group(P<0.01).The visual analogue scale scores of the observation group were significantly lower than those of the control group at 2 h,6 h,12 h,and 24 h after operation(P<0.01).Conclusions Epidural anesthesia combined with tracheal intubation for general anesthesia in patients with SP can reduce hemodynamic fluctuations during surgery,reduce postoperati

关 键 词：自发性气胸 气管插管全麻 硬膜外麻醉 血压 心率 疼痛 

分 类 号：R561.4[医药卫生—呼吸系统] R614[医药卫生—内科学]