【摘要】 目的　观察硬膜外麻醉 (EA)在开胸手术术中、术后的镇痛效果及对呼吸、循环功能的影响。方法　 5 0例呼吸功能正常、心功能Ⅰ～Ⅱ级的胸科病人随机分为两组。对照组采用静脉复合麻醉 ;观察组采用EA加气管粘膜表面麻醉和基础麻醉。结果　 ( 1)观察组在气管插管和断肋骨时SBP、DBP及HR较稳定 ,与对照组相比差异非常显著 ( P <0 0 1)。在拔管后两组SpO2 均有所下降 ,以对照组下降明显 ,组间比较差异非常显著 (P <0 0 1) ;( 2 )观察组术后呼吸恢复快、拔管早 ,两组间拔管时间差异非常显著 (P <0 0 1)。观察组术后止痛时间达 ( 17 80± 4 3 8)h ,未见发生肺部感染。结论　在开胸手术时 ,EA镇痛效果确切 ,术中血压、心率较稳定。术后病人呼吸功能恢复良好更多还原

【Abstract】 Objective To observe the effects of epidural anesthsia(EA) and the influence of it on respiratory and cardiac function during operation and postoperation. Methods Fifty adult patients, ASA grade Ⅰ Ⅱ ,and normal respiratory function,were divided into two groups randomly.Total intravenous anesthesia was used in the control group.EA,tracheal surface anesthesia and basal anesthesia were used in the treatment group. Results (1)SBP, DBP and HR of treatment group were more stable during endotracheal intubation and cutting rib than that of control group ( P<0 01 ).SpO 2 of two groups was both decreased after extubation,but the degree of decreace in the control group was notable.There was significant difference between that two groups ( P<0 01 ).(2)The recovery of respiratory function was quick and the extubation time was early in treatment group.Compared with those in control guoup,there was significant difference ( P<0 01 ).Analgesic duration of treatment group was (17 80±4 38)h,and the infection of lung was not found. Conclusion For the thoracotomy,analgexic effect of EA is stable and SBP , DBP and HR are stable during operation,and the recovery of respiratory funtion is better after operation.更多还原