关键词: 麻醉，吸入;安氟醚;硬膜外阻滞;腹部手术;心率

    摘 要:目的 探讨全麻复合高位硬膜外阻滞对手术患者心率变异性的影响. 方法 40例择期中上腹部手术患者分为安氟醚吸入组(Ⅰ)和安氟醚吸入复合高位硬膜外阻滞组(Ⅱ)，每组20例，利用心率变异功率谱分析法对麻醉前、麻醉诱导后、插管后、麻醉后、切皮后及拔管后心率变异性及血流动力学进行分析. 结果 麻醉诱导后及麻醉后两组LF，LF/HF，TP显著降低;插管后、切皮后及拔管后，Ⅰ组LF，LF/HF及TP显著升高，而Ⅱ组未见明显改变;组间比较显示上述各指标组间均有显著性差异.血流动力学改变与自主神经系统功能变化基本一致. 结论 全麻复合胸段硬膜外阻滞可显著降低交感神经活性、交感/迷走均衡性和植物神经总张力;并显著降低手术刺激对自主神经功能及血流动力学的影响，利于机体血流动力学稳定.

    Effects of enflurane combined with thoracic epidu┐ral anesthesia on heart rate variability of patients undergoing abdominal operations

    JING Gui-Xia，ZHU Yao-Min，YE Ping-An

    Department of Anesthesiology，First Hospital，Xi'an Jiaotong University，Xi'an710061，China

    Keywords:inhaled anesthesia，inhalation;enflurane;epidural block;abdomen surgery;heart rate

    Abstract:AIM To investigate the effects of enflurane com-bined with thoracic epidural anesthesia on the autonomic ner-vous system of patients treated surgically.METHODS Forty patients scheduled for elective abdominal operation were randomly allocated into enflurane group(Ⅰ)and enflu-rane combined with epidural anesthesia group(Ⅱ).Heart rate variability(HRV)was assessed at preanesthesia ......