CAJ | 학술논문

目的：比较浅全身麻醉联合硬膜外麻醉中硬膜外间断给药和持续泵注给药对血液动力学的影响。方法将60例 ASAⅠ—Ⅲ级行结肠癌根治术患者按随机数字表法分成 A、B 组，每组30例。2组均行浅全身麻醉联合硬膜外麻醉，均选择 T10—11间隙硬膜外穿刺。A 组硬膜外间断给药，B 组硬膜外持续泵注给药。记录在全身麻醉插管前和拔管后的麻醉节段数，并以硬膜外首次注入维持量局部麻醉药后每15 min 为一时间点，记录各时点的平均动脉压（MAP）、心率（HR）。结果2组阻滞平面均满足手术要求。A 组术中 MAP 的变化趋势比 B 组明显，A组 MAP 下降幅度＞20％及 HR 上升幅度＞15％的发生率明显高于 B 组（P ＜0．05）；2组全身麻醉插管前和拔管后麻醉节段数比较差异均无统计学意义（P ＞0．05）。结论浅全身麻醉联合硬膜外持续泵注给药麻醉对患者血液动力学影响较小。
목적：비교천전신마취연합경막외마취중경막외간단급약화지속빙주급약대혈액동역학적영향。방법장60례 ASAⅠ—Ⅲ급행결장암근치술환자안수궤수자표법분성 A、B 조，매조30례。2조균행천전신마취연합경막외마취，균선택 T10—11간극경막외천자。A 조경막외간단급약，B 조경막외지속빙주급약。기록재전신마취삽관전화발관후적마취절단수，병이경막외수차주입유지량국부마취약후매15 min 위일시간점，기록각시점적평균동맥압（MAP）、심솔（HR）。결과2조조체평면균만족수술요구。A 조술중 MAP 적변화추세비 B 조명현，A조 MAP 하강폭도＞20％급 HR 상승폭도＞15％적발생솔명현고우 B 조（P ＜0．05）；2조전신마취삽관전화발관후마취절단수비교차이균무통계학의의（P ＞0．05）。결론천전신마취연합경막외지속빙주급약마취대환자혈액동역학영향교소。
Objective To investigate the effects of light general anesthesia combined with epi-dural intermittent administration or continuous pump infusion on hemodynamics.Methods Sixty ASA Ⅰ-Ⅲ patients undergoing radical surgery for colon cancer were randomly divided into two groups,with 30 patients in each group.All patients received light general anesthesia combined with epidural anesthesia(puncture point T10-11 space).Epidural intermittent administration and continuous pump infusion were performed in group A and group B,respectively.The number of anesthetic segments was recorded before intubation and after extubation.In addition,mean arterial pressure(MAP)and heart rate(HR)were measured every 15 minutes after the first injection of maintenance dose of local anesthetic.Results Block plane could meet surgical requirements in both groups.Change in MAP in group A was more obvious than that in group B.The percentage of patients with MAP decrease >20% and HR increase>15% in group A was significantly higher that in group B(P <0.05).There was no significant difference in the number of anesthetic seg-ments between the two groups before intubation and after extubation(P > 0.05).Conclusion Light general anesthesia combined with continuous epidural pump infusion has less influence on hemodynamics.