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《Ningxia Medical Journal》 2003-08
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Feasibility of three different anesthesia for elderly upper abdominal surgery

LIANG Hua,TAO Guo-cai,GUO Yong-jun.(The Fifth Hosp. of PLA,Yinchuan 750004,China)  
Objectives To evaluate the efficacy of three anesthesia for elderly upper abdominal surgery.Methods Sixty ASA Ⅰ-Ⅱ elderly patients,scheduled for elective upper abdominal surgery,were divided randomly into epidural block group(A),general anesthesia group(B) and combined general and epidural anesthesia group(C).The patients were premeditated with intramuscular midazolam 0.1 mg/kg and atropine 0.01 mg/kg.In both A and B groups anesthesia was induced with midazolam 0.2mg/kg,fentanyl 5 μg/kg,etomidate 3mg/kg,propofol 0.5mg/kg atracurium 0.6mg/kg,and was maintain with intravenous infusion of propofol 4-10 ml/h and/or inhalation of 1%-2% enflurane and intermittent bolus of atracurium and fentanyl.In both A and B groups epidural block was performed at T 8,9 and an epidural catheter was place and 0.25% bupivacaine + 1.0% lidocaine 10-15ml was given before induction of general anesthesia and during operation the local anesthetics were infused at rate of 4-7ml/h.hemodynamics was measured with impendence cardiography and intraoperative awareness,postoperative restlessness and anesthetic dosage were recorded,Blood samples were taken before anesthesia,immediately befor operation,30,60,90,120 and after extubation for determination of plasma insulin,cortisol,glucose,epinephrine.Results (1)plasina glucose,cortisol level increased significantly at 30,60,120 min after skin incision and peaked at the end of operation in three group(P0.05) and was slightly lower in group C than another both groups.The difference was significant only at 60 min after skin incision.(2)there are no significant change in insulin during operation.(3)Plasma epinephrine level increased significantly at 30,60 min after skin incision in both A and B groups and peaked at immediately after extubation in group B.(4)MAP HR increased significantly at 30,60 min after skin incision in both A and B groups.And peaked at immediate after extubation in group B and there are no significant change in group C.Conclusions Epidural block combined with general anesthesia is applied better for elderly upper abdominal surgery,and reduces traumatic stimulation produced by surgical opoeration.
【CateGory Index】: R614
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【References】
Chinese Journal Full-text Database 3 Hits
1 LI Xin-yu(Department of Anesthesiology,Jingdong Hospital of Langfang City,Hebei Province,Langfang 065201,China);Exploration of anesthesia at upper abdominal operation in old patient with hypertension[J];Jilin Medical Journal;2007-05
2 LIANG Hua,et al.(The Fifth Hosp. ,the People Republic of China army,Yingchuan 750004,China);The effects of patient controlled epidural analgesia on endocrine function in the elderly after upper abdominal surgery[J];Ningxia Medical Journal;2004-06
3 LIANG Hua,et al.(The 5th Hosp.of PLA,Yinchuan 750004,China);Application of epidural block combined with intravenous fast-tracking anesthesia in elderly patients undergoing upper abdominal surgery[J];Ningxia Medical Journal;2008-05
【Co-references】
Chinese Journal Full-text Database 9 Hits
1 ;Continuous infusion of remifentanil and propofol during cerebral aneurismal occlusion with Guglielmi detachable coil[J];Academic Journal of Second Military Medical University;2006-07
2 LIU Yan-jie,ZHANG Xue-gang,HUANG Zhong-hua,YE Fong-qin. Department of Anesthesia,the People Hospital's of Guangxi Zhuang Autonomous Reg ion(Nanning 530021),China;The effects in pulmonary function of upper abdominal surgery under generalanesthesia combined with epidural block anesthesia in aged patients[J];Guangxi Medical Journal;2005-05
3 CHEN Hui-rong, LI Jun, LIU Yong-qin, et al (Department of Anesthesiology, Naval General Hospital, Beijing 100037, China);Effect of Combined General Anesthesia with Epidural Block on the Stress Response in Patients Undergoing Upper Abdominal Surgery[J];Journal of Naval General Hospital of PLA;2004-03
4 LIANG Hua , TAO Guo-Cai. Department of Anesthesiology, Southwest Hospital, The Thired Military Medical University, Chongqing 400038, China;Feasibilitv of Three Different Mathods of Anesthesia for Upper Abdominal Surgery[J];Military Medical Journal of South China;2004-04
5 HUANG Zhi-liang,ZHENG Zhao-ping,YANG Wen-ke (The Dept.of Anesthesia,The People's Hospital of Jieyang City,Guangdong Jieyang 522000,P.R.China);Effects of general anesthesia combined with epidural block on patients with cardiovascular diseases undergoing upper abdominal operation[J];Journal of Hainan Medical College;2007-01
6 Hong Tao,Wen Daxiang,Hang Yannan.Department of Anesthesiology,Changzhou First People’s Hospital,Changzhou 213003 CHINA;Relationship of postoperative serum S100ββ protein concentration and cognitive dysfunction in elderly patients underwent elective abdominal surgery[J];The Journal of Clinical Anesthesiology;2006-08
7 Cai Yirong,Xue Zhanggang,Zhu Biao. Department of Anesthesiology,Affiliated Zhongshan Hospital,Fudan University,Shanghai 200032 CHINA;Risk factors contributing to postoperative cognitive dysfunction in elderly patients[J];The Journal of Clinical Anesthesiology;2006-08
8 WEI Jia-Jun, ZHANG Jun-Jian, LI Hua-Gang Department of Neurology, Zhong Nan Hospital of Wuhan University, Wuhan 430071, China;Relationship Between S100β and Vascular Cognitive Impairment[J];Chinese Journal of Clinical Neurosciences;2005-01
9 Tong Lei, Wang Hongwei, Ni Qiang, Chen Wurong Department of Anesthesiology, Pu Tuo Affiliated Hospital, Shanghai University of Chinese Traditional Medicine, Shanghai 200062 , China;EFFECTS OF COMBINED GENERAL-EPIDURAL ANESTHESIA ON PLASMA LEVEL OF CORTISOL AND IL-6 IN ELDERLY PATIENTS UNDERGOING UPPER ABDOMINAL SURGERY[J];Gereatrics & Health Care;2005-02
【Secondary References】
Chinese Journal Full-text Database 3 Hits
1 ZHANG Cheng-ju,MA Bao-xin,LI Hong-yue(Department of Anesthesiology,Zhongshan Hospital Affilated to Xiamen University Xiamen 361004,China);Anesthesia of patients with hypertension undergoing abdominal emergency operation[J];Journal of Hainan Medical College;2008-04
2 LIANG Hua,WANG Li-Wen,YANG Huan-Jie,et al.(The Fifth Hosp of PLA,Yingchuan 750004,China);Comparison of effect of ropivacaine-morphine with bupivacaine-morphine on PCEA after abdominal hysterectomy[J];Ningxia Medical Journal;2006-04
3 LIANG Hua,et al.(The 5th Hosp.of PLA,Yinchuan 750004,China);Application of epidural block combined with intravenous fast-tracking anesthesia in elderly patients undergoing upper abdominal surgery[J];Ningxia Medical Journal;2008-05
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