【摘要】 目的比较七氟醚吸入全麻复合硬膜外不同浓度的左旋布比卡因用于老年患者食管癌手术时生命体征的变化。方法老年患者择期开胸食管癌手术60例随机分为2组,组1、组2术中硬膜外分别给予0.375%左旋布比卡因与0.25%左旋布比卡因。硬膜外穿刺成功后行全麻诱导插管,调节吸入七氟醚的浓度使BIS值保持在50～55之间,记录术中各时刻HR、MAP、BIS、七氟醚的呼气末浓度(FESEV)。结果手术开始后90min内组1HR、MAP低于基础值,差异有统计学意义(P<0.05),组2HR、MAP与基础值比差异无统计学意义(P>0.05),组1HR、MAP与组2比下降(P<0.05﹚。90min后组1与组2HR、MAP与T0比较差异无统计学意义(P>0.05),两组间比较差异无统计学意义(P>0.05)。组1与组2比发生低血压与心动过缓的次数增加(P<0.05﹚。结论与0.375%左旋布比卡因相比,七氟醚吸入全麻复合硬膜外0.25%左旋布比卡因用于老年患者食管癌手术,能够满足术中镇痛需求,生命体征也更加稳定。更多还原

【Abstract】 Objective To compare the changes of vital signs among elderly patients undergoing esophageal carcinoma surgery under combined different concentration levobupivacaine and sevoflurane general anesthesia. Methods Sixty elderly patients who were scheduled for esophageal carcinoma surgery were randomly assigned to two groups:Group 1 recives 0.375% levobupivacaine, Group 2 recives 0.25% levobupivacaine. Anesthesia was induced and trachea was intubated when epidural block was successfully performed. Sevoflurane administration was then titrated to maintain BIS between 50 and 55. The HR, MAP, FESEV(End-tidal sevoflurane concentration),BIS were recorded during the surgical procedure. Results HR and MAP were significantly reduced in group 1, not in group 2 within 90 minutes. No significant differences were found between group 1 and 2 after 90 minutes. Significant hypotension and bradycardia occurred in group 1,but not in group 2. Conclusion Epidural administration of 0.25% levobupivacaine combined with sevoflurane general anesthesia leads to an adequate anesthetic depth and less variable values of vital signs when compared with a 0.375% concentration of levobupivacaine.更多还原