不同麻醉方法对高血压妇科手术患者的影响

目的探讨不同麻醉方法对高血压妇科手术患者的影响。方法择期行妇科手术老年患者96例,术前合并I～Ⅱ期高血压,均按WHO标准诊断,随机分成单纯全麻(A组)、全麻复合硬膜外阻滞(B组),每组48例。观察两组麻醉前、插管时、拔管后收缩压(SBP)、平均动脉压(MAP)、和心率(HR)变化,记录两组患者术毕苏醒情况间及不良反应(如术中知晓、术后躁动、恶心、呕吐、肩背痛等)。结果 A组在插管及拔管时的SBP、MAP、HR均明显高于麻醉前值(P<0.05),同期B组无明显变化(P>0.05),组间比较有统计学意义(P<0.05);两组麻醉苏醒时间和术后不良反应比较差异有统计学意义(P<0.01,P<0.05)。结论全麻复合硬膜外麻醉能减少术中应激反应使血流动力学稳定,全麻药量明显减少,术后苏醒快、拔管早,是高血压患者妇科手术较为安全有效的麻醉方法。

The impact of different anesthetic techniques on hypertensive patients with gynecologicalsurgery

Objective To explore the impact of different anesthetic techniques on hypertensive patients with gynecological surgery.Methods 96 cases undergoing elective gynecological surgery in elderly patients,preoperative combining I~II hypertension,according to the WHO criteria for diagnosis,were randomly divided into general anesthesia(group A,48 cases),anesthesia combined with epidural anesthesia block(group B,48 cases).Two groups of patients were observed systolic blood pressure(SBP),mean arterial pressure(MAP) and heart rate(HR) changes before anesthesia,intubation,after extubation,and were recorded surgery to wake up the situation and adverse reactions(such as intraoperative awareness,postoperative agitation,nausea,vomiting,shoulder pain,etc.).Results SBP,MAP and HR were significantly higher than before anesthesia at the time of intubation and extubation in group A(P<0.05),group B have not significant change during the same period(P>0.05),between groups was statistically significant(P<0.05);The difference of anesthesia recovery time and postoperative adverse reactions was statistically significant in two groups(P<0.01,P<0.05).Conclusion Anesthesia combined with epidural anesthesia is safe and effective anesthesia with gynecological surgery in patients of hypertension,because it can reduce the stress response to intraoperative hemodynamic stability and anesthetic quantity,rapid postoperative recovery,as early extubation.