关键词: 乳腺手术;硬膜外阻滞;罗哌卡因;肺功能

    摘 要:目的 探讨乳腺手术选用3.75g L-1 罗哌卡因行上胸段硬膜外阻滞的效果及其对肺通气功能的影响. 方法 选择乳腺肿瘤根治术患者35例，T2～3 椎间隙穿刺行连续硬膜外阻滞，给予10g L-1 利多卡因5mL作为试验量，随后按应用局麻药不同随机分为B组(2.5g L-1 布比卡因)和R组(3.75g L-1 罗哌卡因)，观察吸空气或吸氧下循环、麻醉效果和动脉血气的变化. 结果 两组麻醉效果、局麻药的容量和脊神经阻滞数相仿;HR，SBP，RR和SpO2 变化趋势基本一致;两组麻醉下吸空气的血气分析诸指标与基础值无明显差异，吸氧下PaO2 ，SaO2 和PA O2 均明显较基础值增高(P<0.05). 结论 清醒状态下3.75g L-1 罗哌卡因行上胸段硬膜外阻滞，可避免对肺通气功能影响，能安全、有效地用于乳腺手术患者麻醉.

    Effect of upper thoracic epidural anesthesia with3.75g L-1 ropivacaine on pulmonary function in patients undergoing breast surgery

    CHEN Shao-Yang，XIONG Li-Ze，WANG Qiang，LI Shu-Zhi，DONG Hui，ZHU Xiao-Ling，ZENG Yi Department of Anesthesiology，Xijing Hospital，Fourth Military Medical University，Xi'an710033，China

    Keywords:breast surgery;anesthesia，epidural;ropiva-caine;pulmonary function

    Abstract:AIM To investigate the effect of upper thoracic epidural anesthesia(TEA)with0.375%ropivacaine on pul-monary function in patients undergoing breast surgery.METHODS Thirty-five patients scheduled for removing mastocarcinoma under upper TEA were studied.TEA was performed at the T2～3 interspace by using epidural catheter.The test dose of1%lidocaine was administered.According to the anesthetic solution used ......