摘要
ＡＳＡⅡ～Ⅲ高龄剖胸手术病人４０例，年龄７０～８２岁，随机平分为两组。麻醉过程如下：１。Ｃａｒｄｉｏｃａｐ监护仪持续监测并记录血压、心率及心律的变化。２．组Ⅰ经Ｔ６～７或Ｔ５～６硬膜外穿刺置管并注芬太尼１．５μｇ／ｋｇ，全麻诱导：安定０．２ｍｇ／ｋｇ、２．５％硫喷妥钠４ｍｇ／ｋｇ、芬太尼２μｇ／ｋｇ、潘库溴胺０．１ｍｇ／ｋｇ，手术开始后硬膜外注０．２％布比卡因６ｍｌ。术中全麻过浅时注芬太尼及经回路内注安氟醚０．５ｍｌ／次。组Ⅱ除全麻诱导时芬太尼剂量为３．５μｇ／ｋｇ及无硬膜外用药外，其他同组Ⅰ．３．术后组Ⅰ硬膜外注吗啡镇痛，组Ⅱ肌注听替陡或吗啡镇痛。４．手术前后分别监测血气、潮气量、每分通气量及血氧饱和度的变化。结果表明，硬膜外阻滞加浅全麻用于７０岁以上剖胸手术病人的麻醉，能减少全麻药用量，缓解手术、麻醉引致的应激反应，术中循环功能较平稳，术毕病人早期清醒，术后镇痛效果确实可靠，有利于病人咳嗽排痰，对病人手术后呼吸功能乃至全身功能的早期恢复有益。
Elective thoracotomy was performed in 40 ASA Ⅱ～Ⅲpatients aged from 70 to 82 years old.General anesthesia combined with epidural block was chosen in 20 patients (group Ⅰ).Twenty patients (group Ⅱ)were oper-ated upon under general anesthesia alone. The resuIts show that epidural block in combination with general anesthesia could reduce the dose of general anesthetics and keep cardiovascular function stable。 As the patients of groupⅠ can be expected to recover frorn anesthesia immediately after operation and experience a long time of postoperative pain-relief,it is beneficial to the improvement of pulmonary function postoperatively.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
1995年第2期68-70,共3页
Journal of Clinical Anesthesiology
关键词
硬膜外阻滞
全麻
镇痛
老年
剖胸术
Epidural blockade General anesthesia Pain Anesthesia for elderly patient
