摘要
目的探讨胸段硬膜外麻醉的阻滞平面宽度对全身麻醉诱导期丙泊酚靶控浓度的影响。方法选择2015年10月至2016年3月中国医科大学附属第一医院择期行胃肠肿瘤外科手术的45例患者为研究对象。将45例患者随机分为A、B、C 3组,每组各15例,A组硬膜外给予1%利多卡因10 ml,B组硬膜外给予2%利多卡因5 ml,C组硬膜外穿刺后不给药,留至术中及术后镇痛。硬膜外给药20 min阻滞平面确定后,以2.0μg/ml为起始浓度对患者行丙泊酚血浆靶控注射,患者意识消失时记录各组丙泊酚效应室浓度。结果意识消失时,A、B、C 3组患者的丙泊酚效应室浓度分别为(1.51±0.44)μg/ml、(1.99±0.37)μg/ml、(2.68±0.68)μg/ml,组间比较,差异有显著统计学意义(P<0.05)。结论胸段硬膜外阻滞有镇静作用,可明显降低患者意识消失时丙泊酚效应室浓度,阻滞范围越大效果越明显。
Objective To investigate the effect of thoracic epidural anesthesia（ TEA） on propofol concentration during general anesthesia induction. Methods A retrospective study was performed on 45 patients underwent gastrointestinal surgery from October 2015 to March 2016. Patients were randomly divided into 3 groups（ n = 15 each）,including Group A,patients received 10 ml 1% lidocaine,Group B,patients received 5 ml 2% lidocaine and Group C,patients received no epidural administration,the intraoperative and postoperative analgesia was maintained. Twenty minutes after admimistration,the propofol target-controlled infusion was started to produce a blood concentration of 2. 0 μg/ml and increased until the patient lost consciousness. The propofol effect-site concentration（ Cet） was recorded. Results When the patients lost consciousness,the Cet of Group A,Group B and Group C were（ 1. 51 ± 0. 44） μg/ml,（ 1. 99 ± 0. 37） μg/ml and（ 2. 68 ± 0. 68） μg/ml,respectively. There were statistically significant differences between the 3 groups（ P〈0. 05）. Conclusion TEA with the sedation effect can significantly reduce the propofol effect-site concentration when patients lose consciousness,and the effect can be enhanced with a wider block level.
出处
《临床军医杂志》
CAS
2017年第4期384-386,共3页
Clinical Journal of Medical Officers
基金
辽宁省教育基金(L2010629)
关键词
胸段硬膜外阻滞
丙泊酚
利多卡因
全身麻醉
Thoracic epidural anesthesia
Propofol
Lidocaine
General anesthesia
