摘要
目的:探讨罗哌卡因丁丙诺啡硬膜外阻滞复合全身麻醉对上腹部手术应激反应的影响。方法:60例择期行上腹部手术的患者,随机分成2组:观察组为罗哌卡因丁丙诺啡硬膜外阻滞复合全身麻醉,对照组为单纯气管插管全身麻醉。分别于麻醉前、切皮时、手术开始60 min、术后3 min采集静脉血检测血糖、血清去甲肾上腺素、肾上腺素、血清皮质醇含量;记录患者平均动脉压、心率、全身麻醉用药量及术毕清醒时间。结果:对照组患者血糖、血清去甲肾上腺素、肾上腺素、皮质醇浓度在切皮时、手术开始60 min、术后3 min明显高于麻醉前(P<0.01),且明显高于观察组(P<0.05,P<0.01),观察组患者平均动脉压、心率在切皮时、手术开始60 min、术后3 min均无异常波动,而对照组显著高于麻醉前(P<0.01)。全身麻醉药用量和术毕清醒时间观察组均明显少于对照组(P<0.05,P<0.01)。结论:罗哌卡因丁丙诺啡硬膜外阻滞复合全身麻醉用于上腹部手术可减轻术中的应激反应,对生理干扰小,术毕清醒快,是一种较好的麻醉方法。
Objective To study the influence of epidural block of ropivacaine and buprenophine combined with general anesthesia on stress response in upper abdominal surgery.Methods Sixty patients undergoing upper abdominal surgery were randomly divided into two groups.The experimental group received epidural block of ropivacaine and buprenophine combined with general anesthesia and control group received general anesthesia of catheterization.The concentrations of blood sugar,norepinephrion,epirenamine and cortisol in blood serum were detected before anesthesia,at the time of skin incision,in intraoprative 60 minutes and in postoperative 3 minutes.The mean arterial pressure,the heart rate,the dosage of general anesthesia and the time of postoperative revival were also observed.Results At the time of skin incision,60 minutes in operation and 3 minutes after operation,the concentrations of blood sugar,norepinephrion,epirenamine and cortisol were higher than those before anesthesia in control group（P0.01）and were higher than those in the experimental group（P0.05,P0.01）.The mean arterial pressure and the heart rate did not change significantly at the time of skin incision,in intraoperative 60 minutes and in postoperative 3 minutes in the experimental group but increased significantly in control group（P0.01）.The dosage of general anesthesia and the time of postoperative revival in the experimental group were much less than those in control group（P0.05,P0.01）.Conclusion The epidural block of ropivacaine and buprenophine combined with general anesthesia has light stress response and physiological interference as well as short postoperative revival in upper abdominal surgery.
出处
《中华实用诊断与治疗杂志》
2010年第4期354-356,共3页
Journal of Chinese Practical Diagnosis and Therapy
