摘要
目的：探讨不同浓度的罗哌卡因胸段硬膜外阻滞对单肺通气的影响。方法：选取食管癌患者共120例,随机分成4组,每组各30例。对照组：单纯静脉麻醉,另3组静脉全麻联合0.5%（A组）、0.25%（B组）、0.125%（C组）浓度的罗哌卡因硬膜外阻滞。单肺通气前和单肺通气15 min、30 min后分别抽取患者的混合静脉血进行分析。结果：B组患者的手术时间均短于C组和对照组（P〈0.05）,而4组患者单肺通气时间差异无统计学意义（P〉0.05）;A、B、C组患者芬太尼用量均少于对照组（P〈0.01）;B组患者丙泊酚用量亦少于对照组（P〈0.05）,但A、B组与对照组差异均无统计学意义（P〉0.05）。A组和B组单肺通气15 min与30 min后,SBP、DBP均低于对照组（P〈0.05-P〈0.01）,C组通气15 min SBP亦低于对照组（P〈0.05）,而通气15 min和30 min DBP均高于A组和B组（P〈0.05）。结论：不同浓度罗哌卡因胸段硬膜外阻滞对单肺通气的影响具有差异性,0.125%浓度的罗哌卡因胸段硬膜外阻滞相比而言更安全。
Objective： To investigate the effects of different concentrations of ropivacaine on single lung ventilation in thoracic epidural anesthesia. Methods： One hundred and twenty patients with esophageal cancer were randomly divided into the control group,which were treated with simple intravenous anesthesia,and group A,B and C,whose were treated with intravenous anesthesia combined with 0. 5%,0. 25% and 0. 125% of ropivacaine epidural block,respectively（ 30 cases each group）. The mixed venous blood in all patients were analyzed before single lung ventilation and after 15 and 30 min of single lung ventilation. Results： The operation time in group B was shorter than that in group C and control group（ P〈0. 05）,the differences of single lung ventilation time between 4 groups were not statistically significant（ P〈0. 05）. The fentanyl dosage in A,B and C groups were less than that in control group（ P〉0. 05）. The dosage of propofol in group B was less than that in control group（ P〈0. 05）,but the differences of which between group A,B and control group were not statistically significant（ P〉0. 05）. The SBP and DBP in group A and B were lower than those in control group after 15 and 30 min of single lung ventilation（ P〈0. 05 to P〈0. 01）,the SBP in group C was lower than that in control group after 15 min of lung ventilation（ P〈0. 05）,and the DBP in group C was higher than that in group A and B（ P〈0. 05）. Conclusions： The different concentrations of ropivacaine in epidural block has different effects on the single lung ventilation,the 0. 125% ropivacaine in thoracic epidural anesthesia is safe.
出处
《蚌埠医学院学报》
CAS
2016年第7期912-914,共3页
Journal of Bengbu Medical College
关键词
麻醉
硬膜外
罗哌卡因
单肺通气
epidural anesthesia
ropivacaine
single lung ventilation
