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目的 观察宫颈癌根治术中异丙酚小剂量分次静注辅助硬膜外阻滞的效果。方法 宫颈癌根治术病人40例随机分为两组(每组20例)。A组采用异丙酚0.4～0.5mg/kg分次静注辅助连续硬膜外阻滞;B组全麻气管内插管,吸入异氟醚,间断推注维库溴铵维持麻醉。结果 两组病人麻醉前SBP、DBP、HR无显著差异(P>0.05)。A组病人在腹腔淋巴结清扫时SBP、DBP有较显著的降低(P<0.05),但两组组间比较无显著差异(P>0.05)。手术结束时B组SBP、DBP较麻醉前有较显著的升高(P<0.05),两组组间比较有显著差异(P<0.05)。围手术期两组HR无显著差异(P>0.05)。两组术后清醒情况:B组病人有17例拔管时完全清醒,有3人呼之能睁眼,处于浅睡眠状态。A组病人拔管时均完全清醒。结论 选择小剂量、分次缓慢静注异丙酚辅助连续硬膜外阻滞是宫颈癌根治手术较理想的麻醉方法。
Objective To observe the effect of low-dose propofol intravenous injection of epidural anesthesia in the radical operation of cervical cancer. Methods 40 patients with cervical cancer undergoing radical mastectomy were randomly divided into two groups (20 in each group). A group of propofol 0.4 ~ 0.5mg/kg intravenous injection to assist in continuous epidural anesthesia; B group general anesthesia tracheal intubation, inhaled isoflurane, intermittent bolus injection of vecuronium to maintain anesthesia. Results There was no significant difference in SBP, DBP and HR before anesthesia between the two groups (P>0.05). In group A, there was a significant decrease in SBP and DBP during peritoneal lymph node dissection (P<0.05), but there was no significant difference between the two groups (P>0.05). At the end of surgery, SBP and DBP in group B were significantly higher than those before anesthesia (P<0.05). There was a significant difference between the two groups (P<0.05). There was no significant difference in HR between the two groups during the perioperative period (P>0.05). The two groups were awake after surgery: 17 patients in group B were fully awake during extubation, 3 were able to blink and were in a light sleep state. All patients in group A were completely awake during extubation. Conclusion Selecting low-dose, fractional slow intravenous injection of propofol for continuous epidural anesthesia is an ideal anesthetic method for radical surgery of cervical cancer.