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1、全麻复合硬膜外阻滞不同给药方式用于上腹部手术的临床观察作者：吴秀玲单位：新疆石河子市人民医院麻醉科，新疆石河子【摘要】目的：比较全麻复合硬膜外阻滞麻醉中局麻药硬膜外分次推注与硬膜外负荷剂鼠加微量泵持续注入的麻醉效果与安全性。方法：选择上腹部手术患者40例，随机分A、B组，每组20例。2组硬膜外穿刺确定在换膜外腔后全麻诱导，麻醉机控制呼吸，A组换膜外注入0.5%左旋布比卡因4〜8ml,术中每2小时追加3~6ml；B组0.5%左旋布比卡因负荷剂量3〜5ml后用微量泵以2~4ml/h持续注入至术毕。术中连续监测心电图(ECG)、4W(HR)、血氧饱和度(SPO2)、收缩压(SBP
2、)、舒张压(DBP)、平均动脉压(MAP)。结果：A组与B组比鐵硬膜外用跖5min时SBP、DBP、MAP差异有统计学意义(P<0.05),A组硬脱外川药5min时与麻醉前比较SBP、DBP、MAP差异有统计学意义(PV0.05)。结论：全麻复合硬膜外阻滞麻醉中，采用硬膜外微量泵恒速注药对病人生理干扰小，麻醉效果好，血流动力学平稳。【关键词】全麻换膜外注药微量泵上腹部手术Combinationofgeneralanesthesiawithepiduralblockinthedifferentwaysofadministrationonupperabdominaloperat
3、ionWUXiu-ling,SONGBin,LIUAi-ping(DepartmentofAnesthesiology,ThirdAffiliatedHospital,MedicalCollegeofShiheziUniversity,Shihezi832000,China)Abstract:Objective:Tocomparetheeffectsandsafetyoftheintervalepiduralinfusionwiththoseofthecontinuousoneusingmicropumpafterinitialloadingdosageinthecombi
4、nationofgeneralanesthesiawithepiduralblock.Methods:Thefortycasesonupperabdominaloperationwererandomizedintotwogroups(AandB)eachofwhichcontainedtwenty.Thegroupsweresimultaneouslygivengeneralanesthesiainductionandrespirationcontrolledbyanestheticmachineafterepiduralpinwasascertainedinthecavi
5、tasepiduralis・TheL-bupivacaine(0.5%,4〜8ml)wasinfusedinitiallybeforeit(0.5%,3〜6ml)wasadministratedinintervalofeverytwohoursduringtheoperationsinthegroupA.Theloadingdosage(0.5%,3〜5ml)ofL-bupivacainewasinfusedinitiallybeforeit(0.5%,2〜4ml/h)wasgivencontinuouslywithmicropumpinthegroupBuntiloper
6、ationwasfinished.ThecontinuousmonitoringwascarriedoutforECGHR,SPO2,SBP,DBPandMAPduringoperation.Results:ComparedgroupAwithBat5minutesintheepiduralinfusion,therewerethestatisticalsignificancsintheSBP,DBPandMAP(P<0.05).Comparedat5minutesintheepiduralinfusionwithbeforecombinedanesthesiaintheg
7、roupA,therewerethestatisticalsignificancsintheSBP,DBPandMAP(P<0.05).Conclusion:Itsuggestedthatcontinuousepiduralinfusionbymicropumpcouldmakephysiologicalfunctionlessaffected,anesthesiaeffectsatisfactoryandhaemodynamicssteadyforpatientsinthecombinationofgeneral
