摘要
目的 比较异丙酚靶控输注复合硬膜外阻滞与单纯全麻用于胃癌根治术对围术期血流动力学及术毕清醒时间等的异同。方法 60例 (ASAI～II级 )胃癌根治术病人随机分为异丙酚靶控输注复合硬膜外阻滞 (GE组 )组与单纯全麻 (G组 )组2组 (n=30) ,两组诱导用药相同 ;G组术中持续吸入异氟醚 ,GE组靶控输注异丙酚 ,硬膜外按需追加局麻药 ;2组均用阿曲库铵维持肌松。结果 2组病人基础HR、MAP均无显著性差别。全麻诱导后 ,2组病人HR、MAP与基础值相比有显著下降 ,GE组较G组下降更显著 ( p<0.05) ;气管插管后 ,G组于1min、3min时HR增快 ,而GE组HR始终保持在较稳定水平。G组插管后MAP有一过性增高 ,且在切皮、分离胃体、手术1.5h3个时点的HR、MAP均高于GE组 ( p<0.05) ;GE组插管后MAP仍略低于基础值 ,随后及术中MAP保持在基础值水平。2组术中AEPi均低于45。术毕停药后 ,G组病人23.5±10.5min时可唤醒 ,而GE组病人10.2±3.1min即可唤醒 ( p<0.01)。结论
Objective To compare the effects of combined target controlled infusion with propofol-epidural anesthesia(GEA)and general anesthesia(GA)on gastric carcinoma radical resection. Methods 60patients(ASA class I-II)performed gastric carcinoma radical resection were ranˉdomly divided into2groups.30cases were under GEA,while the others were under GA.In the GEA group,patients firstly received epidural blockade at T9-10or T10-11.Then after tracheal intubation,GEA group patients were maintained by target controlled infusion with propofol,atracurium and epidural local anesthetics.While for GA group,they were with isoflurane and atracurium. Results There is no difference for MAP and HR for GEA and GA group before anesthesia,but both were decreased after induce,and for GEA group,there is significantly decrease(P<0.05).After intubation,HR was increased obviously for GA group,while GEA group patients were stable.During the operation,the hemodynamics(MAP,HR)of GEA group was more stable than GA group.The AEPi of both groups were lower than45.The recovery quality of GEA group was better than GA group. Conclusion Combined target controlled infusion with propofol-epidural block is better than simply general anesthesia in gastric carcinoma radical resection.
出处
《浙江临床医学》
2004年第10期853-854,共2页
Zhejiang Clinical Medical Journal
关键词
单纯全麻
异丙酚靶控输注
硬膜外阻滞
胃癌根治术
病人
术中
插管
Propofol Target controlled infusion(TCI)AEPi Hemodynamics Recovery time Gastric carcinoma radical resection
