临床麻醉学杂志
臨床痳醉學雜誌
림상마취학잡지
THE JOURNAL OF CLINICAL ANESTHESIOLOGY
2009年
12期
1046-1048
,共3页
心率变异性%腹腔镜下胆囊切除术%局部麻醉
心率變異性%腹腔鏡下膽囊切除術%跼部痳醉
심솔변이성%복강경하담낭절제술%국부마취
Heart rate variability%Laparoscopic cholecystectomy%Local anaesthetics
目的 探讨全麻复合局部浸润麻醉对腹腔镜下胆囊切除术(LC)患者术中和术后血流动力学和心率变异性(HRV)的影响.方法 择期行LC患者70例,随机分为全身麻醉组(GA组)和全身麻醉复合局部浸润麻醉组(GI组),每组35例,监测并记录患者入室后(T_0)、切皮时(T_1)、缝皮时(T_2)、术后1 h(T_3)、3 h(T_4)HRV的变化,并对血流动力学进行分析.结果 T_1、T_3、T_4时,GA组MAP、HR均较T_0增高(P<0.05),GL组变化均较GA组小.GA组低频标准化值(Lfnu)、LF/HF在T_1～T_4时均较T_0时显著升高(P<O.05).GL组LF/HF在T_1、T_2时均较T_0时升高(P<0.05),且在T_3、T_4时GL组较GA组小;两组总功率(TP)在T_1～T_3时均较,T_0时降低(P<0.05).结论 全麻联合局部浸润麻醉对LC患者术中和术后心率变异性的影响小,可显著降低手术刺激对自主神经功能及血流动力学的影响.
目的 探討全痳複閤跼部浸潤痳醉對腹腔鏡下膽囊切除術(LC)患者術中和術後血流動力學和心率變異性(HRV)的影響.方法 擇期行LC患者70例,隨機分為全身痳醉組(GA組)和全身痳醉複閤跼部浸潤痳醉組(GI組),每組35例,鑑測併記錄患者入室後(T_0)、切皮時(T_1)、縫皮時(T_2)、術後1 h(T_3)、3 h(T_4)HRV的變化,併對血流動力學進行分析.結果 T_1、T_3、T_4時,GA組MAP、HR均較T_0增高(P<0.05),GL組變化均較GA組小.GA組低頻標準化值(Lfnu)、LF/HF在T_1～T_4時均較T_0時顯著升高(P<O.05).GL組LF/HF在T_1、T_2時均較T_0時升高(P<0.05),且在T_3、T_4時GL組較GA組小;兩組總功率(TP)在T_1～T_3時均較,T_0時降低(P<0.05).結論 全痳聯閤跼部浸潤痳醉對LC患者術中和術後心率變異性的影響小,可顯著降低手術刺激對自主神經功能及血流動力學的影響.
목적 탐토전마복합국부침윤마취대복강경하담낭절제술(LC)환자술중화술후혈류동역학화심솔변이성(HRV)적영향.방법 택기행LC환자70례,수궤분위전신마취조(GA조)화전신마취복합국부침윤마취조(GI조),매조35례,감측병기록환자입실후(T_0)、절피시(T_1)、봉피시(T_2)、술후1 h(T_3)、3 h(T_4)HRV적변화,병대혈류동역학진행분석.결과 T_1、T_3、T_4시,GA조MAP、HR균교T_0증고(P<0.05),GL조변화균교GA조소.GA조저빈표준화치(Lfnu)、LF/HF재T_1～T_4시균교T_0시현저승고(P<O.05).GL조LF/HF재T_1、T_2시균교T_0시승고(P<0.05),차재T_3、T_4시GL조교GA조소;량조총공솔(TP)재T_1～T_3시균교,T_0시강저(P<0.05).결론 전마연합국부침윤마취대LC환자술중화술후심솔변이성적영향소,가현저강저수술자격대자주신경공능급혈류동역학적영향.
Objective To investigate the effect of combined general anesthesia with localanesthetic infiltration on heart rate variability and hemodynamics in laparoscopic cholecystectomy.Methods By simple randomization 70 patients undergoing laparoscopic cholecystectomy were assignedto two groups,68 patients completed the study(34 in each group).Group GA was given generalanesthesia.Group GL was given general anesthesia combined with local anesthetic.Iow-frectuency(LF),high-frequency(HF),LF/HF,Lfnu(LF/TP×100%),Hfnu(HF/TP×100%)and totalpower(TP),were recorded at the time points of baseline(T_0),skin incision(T_1),skin closure(T_2)and 1 h(T_3),3 h(T_4)after surgery.MAP and HR were recorded at the points of baseline,skinincision,skin closure and 1,3 h after surgery.Results Compared with the baseline,there was anincrease in MAP and HR at T_1,T_3,T_4(P<0.05)in group GA. Heart rate variability changesshowed that in group GA Lfnu,LF/HF increased significantly at T_1-T_4(P<0.05)and in group GLLF/HF increased significantly at T_1,T_2(P<0.05),and TP in group GA and group GL decreasedsignificantly at T_1,T_2(P<0.05).Conclusion Our results support that combined general anesthesiawith local anesthetic infiltration has lass influence on hemodynamics and automomic nerve,and can bean useful analgesic adjuvanct for patients undergoing laparoscopic cholecystectomy. (
