利多卡因硬膜外阻滞复合全麻对肺癌患者术后相关指标的影响

发布时间：2018-04-12 23:03

本文选题：利多卡因 + 硬膜外阻滞　；参考：《中国药房》2017年12期

【摘要】：目的:探讨利多卡因硬膜外阻滞复合全麻对肺癌患者术后相关指标的影响。方法:回顾性分析108例行手术治疗的肺癌患者资料,按麻醉方式的不同分为观察组(56例)和对照组(52例)。两组患者均静脉滴注异丙酚注射液和芬太尼注射液的复合液,并辅助吸入1%吸入用七氟醚辅助麻醉,间断静脉滴注注射用维库溴铵维持肌松。在此基础上,观察组患者硬膜外输注2.0%盐酸利多卡因注射液5 m L/h维持麻醉;对照组患者硬膜外输注0.9%氯化钠注射液5 m L/h维持麻醉。观察两组患者麻醉时间、手术时间、术中出血量、术后苏醒时间,芬太尼、异丙酚、维库溴铵、七氟醚使用量,术后麻醉相关并发症(恶心、呕吐、头晕、嗜睡、皮肤瘙痒)及其他并发症(心功能不全、心血管事件、房颤、感染、短暂性脑缺血、急性冠状动脉综合征、脑卒中)发生情况,术后4 h及1、2、3、4、5 d的活动与平静时疼痛视觉模拟(VAS)评分。结果:观察组患者麻醉时间、手术时间、术中出血量、术后苏醒时间,芬太尼、异丙酚、七氟醚使用量,术后4 h、1、2 d平静时的VAS评分及术后4 h、1、2、3 d活动时的VAS评分、嗜睡发生率均显著短于或低于对照组,头晕发生率显著高于对照组,差异均有统计学意义(P0.05);两组患者维库溴铵使用量,其他时间平静与活动时的VAS评分,恶心、呕吐、皮肤瘙痒、心功能不全、心血管事件、房颤、感染、短暂性脑缺血、急性冠脉综合征及脑卒中发生率比较,差异均无统计学意义(P0.05)。结论:利多卡因硬膜外阻滞复合全麻可减少肺癌患者术中出血量,降低术后疼痛程度,缩短术后苏醒时间,且未增加术后并发症的发生。
[Abstract]:Objective: to investigate the effect of lidocaine epidural block combined with general anesthesia on postoperative indexes in patients with lung cancer.Methods: the data of 108 patients with lung cancer treated by operation were analyzed retrospectively. According to the different anesthetic methods, the patients were divided into observation group (n = 56) and control group (n = 52).In both groups, propofol and fentanyl injection were injected intravenously with 1% inhaled sevoflurane as adjuvant anesthesia, and vecuronium for intermittent intravenous injection was used to maintain muscle relaxation.On this basis, epidural infusion of 2.0% lidocaine hydrochloride injection 5 mL / h was maintained in the observation group and 0.9% sodium chloride injection 5 mL / h was maintained in the control group.Anaesthesia time, operation time, intraoperative bleeding, postoperative recovery time, fentanyl, propofol, vecuronium, sevoflurane usage, postoperative anaesthesia related complications (nausea, vomiting, dizziness, lethargy) were observed.Skin itching) and other complications (cardiac insufficiency, cardiovascular events, atrial fibrillation, infection, transient cerebral ischemia, acute coronary syndrome, stroke),The activity and visual analogue of pain were assessed at 4 hours and 1 hour and 3 minutes and 4 days after operation.Results: in the observation group, the anesthetic time, operative time, intraoperative bleeding volume, postoperative recovery time, fentanyl, propofol, sevoflurane usage, VAS score at 1 / 2 day after operation and VAS score at 4 h / 12 ~ 2d activity were observed in the observation group.There was no significant difference in the incidence of pruritus, cardiac insufficiency, cardiovascular events, atrial fibrillation, infection, transient cerebral ischemia, acute coronary syndrome and stroke.Conclusion: Lidocaine epidural block combined with general anesthesia can reduce the amount of intraoperative bleeding, reduce the degree of postoperative pain, shorten the time of postoperative recovery, and not increase the incidence of postoperative complications in patients with lung cancer.
【作者单位】：海南省农垦总医院麻醉科;
【分类号】：R614;R734.2

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