不同浓度左布比卡因硬膜外麻醉复合全麻对结肠手术的影响

发布时间：2018-03-05 22:14

本文选题：结肠肿瘤　切入点：左布比卡因　出处：《实用医学杂志》2015年20期 　论文类型：期刊论文

【摘要】：目的:评估左布比卡因硬膜外复合全身麻醉对结肠手术的影响。方法:择期行结肠癌手术的60例患者随机、双盲分为4组,对照组(S组)、0.125%左布比卡因组(L1组)、0.25%左布比卡因组(L2组)及0.5%左布比卡因组(L3组),各15例。S组硬外注射首量生理盐水10 m L,随后5 m L/h泵注至术毕,L1、L2、L3组则选用左布比卡因。硬膜外穿刺后行麻醉诱导,记录入室5 min、插管1 min、切皮、探查、开刀1 h、术毕、拔管、离开复苏室八个时点的平均血压、心率,并测血糖、皮质醇,记录麻醉时间、复苏室时间,出血量、输液量、不良反应,异丙酚、瑞芬太尼、麻黄素、芬太尼总量。结果:S组复苏时间长于其他3组,L1组瑞芬太尼、芬太尼大于L2、L3组,L3组麻黄素大于其他3组;L1组血糖高于L2、L3组,皮质醇高于L3组,L3组低血压例数高于其他3组。结论:0.25%左布比卡因硬膜外输注可减少应激反应,节俭阿片药物,减少复苏时间,不增加麻黄素使用。
[Abstract]:Objective: to evaluate the effect of epidural combined general anesthesia with levobupivacaine on colon surgery. Control group, group S, 0.125% levobupivacaine, group L _ 1, group L _ 2, group L _ 2, and group L _ 3, 0.5% left bupivacaine group, 15 patients in group S were given the first intradural injection of normal saline 10 mL, and then 5 mL / h pump was injected to L1L _ 2L _ 2L _ 3 group. Anesthesia induction after epidural puncture, The mean blood pressure, heart rate, blood glucose, cortisol, anaesthesia time, resuscitation chamber time, blood loss, infusion volume were recorded at five minutes, one minute intubation, one hour of incision, one hour after operation, extubation, leaving the resuscitation room, and leaving the resuscitation chamber. Results the resuscitation time of group 1 was longer than that of group L 1, and the duration of remifentanil in group L was higher than that of group L 2, group L 3, ephedrine was higher than that of group L 1, and the blood glucose of group L 3 was higher than that of group L 2 L 3. ConclusionThe epidural infusion of 0.25% levobupivacaine can reduce stress reaction, save opioid, reduce resuscitation time and do not increase ephedrine use.
【作者单位】：中山大学附属第一医院麻醉科;
【基金】：广东省自然科学基金资助项目(编号:S2012010010965)
【分类号】：R614.2

【参考文献】