摘要
目的:比较单纯全麻和硬膜外复合全麻在60岁以上老年患者开胸手术中对患者血流动力学和苏醒时间的影响.方法:选择30例60岁以上择期开胸手术患者,随机分为单纯全麻组(GA组)和硬膜外复合全麻组(EGA组),每组15例,连续监测ECG、BP、SpO2,并记录入室后10 min安静状态下基础值(T1)、插管后1 min(T2)、5 min(T3)、手术开始后1 min(T4)、60 min(T5)、拔管即刻(T6)6个时点的收缩压(SBP)、舒张压(DBP)、心率(HR)值,并记录术毕苏醒时间.结果:GA组患者HR与基础值差异均无显著性(P>0.05),SBP在T2、T4和T6均高于T1点(P<0.05～P<0.01),而EGA组患者HR除T6外,其余各时点HR均低于基础值(P<0.05～P<0.01),SBP在各时点与T1间差异均无显著性(P>0.05).GA组HR、SBP、DBP在T2～T6各时点均高于EGA组(P<0.05～P<0.01).EGA组苏醒时间明显短于GA组(P<0.01).结论:硬膜外复合全麻比单纯全麻更能保持老年患者在开胸手术中血流动力学的稳定性,并能缩短术毕苏醒时间.
Objective：To observe and compare the influence of two different anesthesias on the homodynamic and awakening time of patients over 60 receiving thoracic surgery. Methods： Thirty ASA Ⅰ- Ⅱ status patients older than sixty undergoing thoracic surgery were randomly divided into two groups with 15 cases each, the general anesthesia group（GA group） and the epidural combined general anesthesid group（EGA group）. The ECG, BP, and SpO2 were measured constantly. The baseline values before anesthesia（T1）, 1 minute（T2） and 5 minutes （ T3 ） after incubat ion, 1 minute （T4） and 60 minutes （ T5 ） during operation, and extubation （T6 ） were recorded.The awakening time was observed. Results： In GA group, HR did not have statistical difference compared to the baseline values before anesthesia（P 〉 0.05 ）. SBP increased sign ficantly（P 〈 0.05 - P 〈 0.01 ） at T2, T4 and T6. In EGA group, HR, except at T6, decreased significantly（P 〈 0.05 - P 〈 0.01 ） compared to the baseline values before anesthesia, but SBP had no statistical difference compared to the baseline values（P 〉 0.05）. All values of HR, SBP, DBP at T2 - T6 in GA group were higher than those in EGA group（P〈 0.05 - P 〈 0.01）. The awakening time was shorter in EGA group than in GA group. Conclusions： Epidual-general anesthesia can maintain the homodynarnic stability better and shorten the awakening time of the old patients undergoing thoracic surgery.
出处
《蚌埠医学院学报》
CAS
2005年第5期407-409,共3页
Journal of Bengbu Medical College
关键词
麻醉
硬膜外
麻醉
全身
血流动力学
苏醒时间
老年医学
anesthesia, epldural
anesthesia, general
hemctlynamic
awakening time
geriatrics
