全身麻醉复合罗哌卡因硬膜外阻滞应用于食道癌手术中的麻醉效果观察

发布时间：2018-10-25 08:50

【摘要】：目的观察全身麻醉复合罗哌卡因硬膜外阻滞应用于食道癌手术中的麻醉效果。方法将66例择期行食道癌手术的患者随机分为两组,全身麻醉组(A组)32例给予全身麻醉处理,全麻复合硬膜外阻滞组(B组)34例给予全麻复合罗哌卡因硬膜外阻滞麻醉处理,对比两组各时间点平均动脉压(MAP)、心率(HR)等血流动力学情况及术后清醒拔管时间、镇痛效果、麻醉药物用量等情况。结果 B组术中血流动力学相对平稳,优于A组(P0.05);B组插管后至拔管后血清皮质醇、血浆肾上腺素水平低于A组(P0.05);B组麻醉药物使用量、术后拔管时间、疼痛评分(VAS评分)均低于A组(P0.05);B组术后躁动发生率为5.8%,肺部感染发生率为2.9%,低于A组的28.1%、21.9%(P0.05)。结论与单纯全身麻醉相比,全麻复合罗哌卡因硬膜外阻滞麻醉应用于食道癌手术能有效减少术中麻醉药物的使用量,血流动力学相对稳定,具有苏醒质量高、镇痛效果好等优势,具有推广价值。
[Abstract]:Objective to observe the anesthetic effect of general anesthesia combined with ropivacaine epidural block in esophageal cancer surgery. Methods 66 patients with esophageal cancer were randomly divided into two groups: general anesthesia group (group A), general anesthesia group (group A, n = 32), general anesthesia combined with epidural block group (group B, n = 34), general anesthesia combined with ropivacaine epidural block, and general anesthesia combined with ropivacaine epidural block. The hemodynamics such as mean arterial pressure (MAP), heart rate (HR) and postoperative time of extubation, analgesic effect and dosage of anesthetic were compared between the two groups. Results the hemodynamics of group B was relatively stable during operation, which was better than that of group A (P0.05); B group after intubation and extubation), and the level of plasma epinephrine was lower than that in group A (P0.05); B group). Pain score (VAS score) was lower than group A (P0.05); B group postoperative restlessness rate was 5.8, lung infection rate was 2.9%, lower than group A 28.1% (P0.05). Conclusion compared with general anesthesia alone, general anesthesia combined with ropivacaine epidural block anesthesia can effectively reduce the amount of anesthetic used in esophagus cancer surgery, the hemodynamics is relatively stable, and the quality of recovery is high. The analgesic effect is good and so on, has the popularizing value.
【作者单位】：湖北襄阳市中心医院(湖北文理学院附属医院)麻醉科;湖北襄阳市中心医院(湖北文理学院附属医院)消化内科;
【分类号】：R614;R735.1

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