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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2002年第6期

页码:

482-484

栏目:

临床研究

出版日期:

2002-11-01

文章信息/Info

Title:

A comparative study of cardiovascular effects of general anesthesia and combined anesthesia of general anesthesia and thoracic epidural blockade with ropivacaine

作者:

侯立朝;  熊利泽;  熊东方;  张英民;  李树志;  李秀娜

第四军医大学西京医院麻醉科, 陕西西安 710032

Author(s):

HOU Li-chao; XIONG Li-ze; XIONG Dong-fang; ZHANG Ying-min; LI Shu-zhi; LI Xiu-na

Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi 710032,China

关键词:

罗哌卡因;  全身麻醉;  硬膜外阻滞;  血压;  心率

Keywords:

ropivacaine;  general anesthesia;  epidural blockade;  blood pressure;  heart rate

分类号:

R614.2

DOI:

-

文献标识码:

A

摘要:

目的 比较罗哌卡因胸段硬膜外阻滞复合全麻(CGA)和单纯全麻(GA)用于全胃切除手术时的心血管效应。方法 40例拟择期行全胃切除手术患者,ASAⅠ~Ⅱ级,随机分为GA组和CGA组,每组20例,分别接受气管插管全麻和罗哌卡因胸段硬膜外阻滞复合气管插管全麻。记录麻醉诱导期、手术期及苏醒期的血压、心率变化。结果 ①CGA组患者术中收缩压、心率的变化均较GA组小(123±14 mm Hgvs132±17 mm Hg和78±10/minvs85±10/min,均P<0.01);②CGA组患者诱导插管时及苏醒期的血压、心率变化均较GA组小(均P<0.05)。结论 与GA相比,CGA用于全胃切除手术可维持更加稳定的血流动力学,且特别适用于有心肌缺血或存在心肌缺血倾向的手术患者。

Abstract:

AIM To make a comparative study of cardiovascular effect of general anesthesia and combined anesthesia of general anesthesia and thoracic epidural blockade with ropivacaine. METHODS 40 patients scheduled for elective whole gastrectomy with ASAⅠ~Ⅱ, which were randomly divided into GA (general anesthesia) group (n=20) and CGA (combined general anesthesia) group (n=20), received general anesthesia with tracheal intubation and combined anesthesia of general anesthesia with tracheal intubation and thoracic epidural blockade with ropivacaine. Changes in blood pressure and heart rate during the period of anesthesia induction, operation and awake were recorded.RESULTS ①Changes of systolic blood pressure and heart rate during operation in CGA group were smaller than in GA group (123±14 mm Hgvs132±17 mm Hg and 78±10/minvs85±10 min-1respectively,P<0.01).②Blood pressure and heart rate changes to intubation and awake were smaller in CGA group than in GA group (P<0.05).CONCLUSION Combined anesthesia of general anesthesia and thoracic epidural blockade with ropivacaine when applied to whole gastrectomy could maintain more stable hemodynamics compared with general anesthesia, especially suitable to surgical patients having or being predisposing to have myocardial ischemia.

参考文献/References

[1] 潘宁玲,王汝敏,刘家文,等.全麻复合硬膜外阻滞抑制上腹部手术应激反应[J].临床麻醉学杂志, 2000,16(10):493-494.

[2] 陈志扬,薛张纲,蒋豪.全麻复合胸段硬膜外阻滞对兔实验性心肌梗死应激反应的影响[J].中华麻醉学杂志, 2000,20(11): 684-686.

[3] 张 莹,庄心良.高胸段硬膜外阻滞和冠状动脉疾病[J].国外医学(麻醉学与复苏分册), 2000,21(6):323-326.

[4] 方 华,方宝臻,邓硕增.胸部硬膜外镇痛与冠状动脉疾病[J].国外医学(麻醉学与复苏分册), 1999, 20(2):109-111.

[5] 张生锁,潘贤必.应用TEA技术处理顽固性心绞痛[J].国外医学(麻醉学与复苏分册), 1999;20(2):111-113.

[6] 周 权,岳 云.胸部硬膜外麻醉在冠心病病人中的应用[J].国外医学(麻醉学与复苏分册), 2000,21(4):220-222.

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备注/Memo

备注/Memo:

收稿日期：2001-06-04.

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更新日期/Last Update: 2002-11-01