The Clinical Value of Epidural Block Combined with General Anesthesia in Surgical Operation for High-risk Aged Patients
FU Shanming, CHEN Lüxiu, ZHUANG Ziyan. Department of Anesthesiology, Huizhou Hospital of Traditional Chinese Medicine , Guangdong Province 516000
Objective: To assess the practicability of epidural block combined with complex general anesthesia applying low dose and concentration of drug for high-risk aged patients. Methods: 35 high-risk aged patients (ASA grade II-IV) were punctured to epidural according to their surgical area and injected with 1.5%～1.7%lidocaine by 4～6mL,and then measured blockade range after 5～10min. Local anesthetic could be added on the basis of blockade level in order to control blockade level within the required ranges. Midazolam 0. 1mg.kg -1 ,fentanyl 3～5μg.kg -1 , and esmeron 0.2mg.kg -1 were used for induction of general anesthesia. According to the clinic situation, 0. 1mg%fentanyl was associated with 4mg% veuronim bromide (5～15mL·h -1 for injection) during general anesthesia, interrupted by the injection of vecuronim bromide so as to maintain muscle relaxation. Patients’cardiovascular function should be inspected by the multi-functional patient monitor. Plasma levels of angiotensin II (AngII) and blood sugar should be determined respectively before skin incision and after surgery.Results: Complex general anesthesia of epidural blockade was suitable for surgery of high-risk aged patients. If blood pressure declines during the induction of anesthesia, it can be corrected by the supplement of liquid.Conclusion: The application of complex general anesthesia combined with epidural block for high-risk aged patients can set the blood flow dynamics at rest and lighten the emergency reaction. Dose of medicine for general anesthesia and agitation after surgery are decreased.However, care must be taken that only low dose and concentration of local anesthetic can be applied high-risk aged patients.The dose of diprivan should be reduced during the intubation.