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快速康复外科理念在胆道探查术麻醉中的应用 被引量:1

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摘要 [目的]探讨硬膜外复合全麻在快速康复外科胆道探查中的临床意义.[方法]选择自2007年8月至2009年12月在本院行胆道探查术患者160例,按住院号随机分快速康复组(采用硬膜外,复合全麻,试验组)和传统的单纯全麻组(对照组).试验组在全麻诱导前于T10~11硬膜外穿刺置管分两次注入0.75%罗哌卡因共6~10 mL,测麻醉平面后全麻气管插管,两组均以咪唑安定,丙泊酚、舒芬太尼、阿曲库铵诱导麻醉.其中试验组以硬膜外麻醉+异氟醚+阿曲库铵维持麻醉,术后硬膜外镇痛;对照组以导氟醚+丙泊酚+舒芬太尼+阿曲库铵维持麻醉,术后静脉镇痛.记录患者全麻用药总量,术后清醒,拔管时间及清醒质量,镇痛效果,患者下床活动时间,恶心、呕吐发生率.[结果]试验组与对照组比较:全麻用药量少(P〈0.05),清醒拔管时间短(P〈0.01),清醒质量优(P〈0.01 ),下床活动时间早、恶心呕吐率低(P〈0.05).镇痛效果更佳(P〈 0.05).[结论]硬膜外复合用于快速康复外科胆道探查能减少全麻药的用量,有利于患者术后快速苏醒,而术后硬膜外镇痛更能减少阿片类镇痛药的应用,术后全麻药副作用减少,有利于患者尽早下床活动,加速患者康复,缩短住院时间,节约住院费用。
出处 《医学临床研究》 CAS 2011年第10期1998-1999,共2页 Journal of Clinical Research
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