全麻与全麻联合硬膜外阻滞在胃癌根治术中的效果比较(1)
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[摘要] 目的 观察并比较全麻与全麻联合硬膜外阻滞方法在胃癌根治术中的临床效果。方法 选择50例(ASA Ⅰ～Ⅱ级)择期行胃癌根治术的患者随机分成两组，每组25例，A组为全麻组，B组为全麻联合硬膜外阻滞组。A组患者常规给予全麻诱导，气管内插管，术中用丙泊酚、芬太尼、阿曲库胺维持。B组患者先行硬膜外麻醉，起效后行全麻诱导，气管内插管，术中用丙泊酚泵入维持。比较两组全麻药用量、拔管时间及清醒时MAC、Steward苏醒评分及术后镇痛情况。结果 A组全麻药用量明显多于B组(P<0.01)，A组拔管时间明显长于B组(P<0.01)，B组术后清醒时MAC较A组降低，Steward苏醒评分高。结论 全麻联合硬膜外阻滞用于胃癌根治术，可以降低术中全麻药的用量，缩短拔管时间，增强麻醉的安全性。
[关键词] 全麻；硬膜外阻滞；胃癌根治术
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2011)23-121-02
Comparison of the Clinical Effect between General Anaesthesia and General Anaesthesia Combined with Epidural Block in Radical Gastrectomy
BAN Chongyun1 WANG Haibo2
1.Department of Anesthesiology, the People's Hospital of Puer, Puer 665000, China; 2.Department of Anesthesiology, the First Affiliated Hospital of Kunming Medical University, Kunming 650031, China
[Abstract] Objective To observe and compare the clinical effect between general anaesthesia and general anaesthesia combined with epidural block in radical gastrectomy. Methods Fifty patients with ASA Ⅰ-Ⅱ who underwent radical gastrectomy were selected and randomly divided into two groups, each group comprised of 15 cases. Group A comprised of patients who underwent the method of general anaesthesia, and group B comprised of patients who underwent the method of general anaesthesia combined with epidural block. Patients of group A were given general anesthesia induction and endotracheal tube. Propofol, fentanyl and atracurium besylate were used to retain. Patients of group B underwent the method of epidural block firstly. After onset of anesthesia, the patients were given endotracheal tude. During the surgery, propofol was used to retain. Then, we compared the amount of anesthetics, extubation time, MAC awake, steward awakening score and postoperative analgesia. Results The amount of anesthetics in group A was more than that of group B (P<0.05). Extubation time in group A was longer than that in group B (P<0.05). MAC awake in group B was lower than that in group A, and steward awakening score was higher ......
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