The Effect Of The General Anesthesia With Epidural Block Anesthesia On Cardiac Function And Catecholamine In Patients Undergoing Thoracotomy

Objective:To observe the effects of general anesthesiaand general anesthesia with thoracic epidural block on hemodynamics,blood glucose, catecholamine, respiratory and cardiac function inpatients undergoing thoracic surgery and find out the moreeffective anesthesia method for patients with thoractomy.Methods: Sixty adult patients of either sex with normalrespiratory function, ASA grade Ⅰ ～ Ⅲ, were divided intoA(general anesthesia) and B(general anesthesia with thoracicepidural block) groups randomly (n=30,in each group). Both groupswere injected atropine(0.01mg/kg) and diazepam(0.02mg/kg)30min ahead operation. Patients in group A were performed onlywith the routine method. General anesthesia was induced byfentanyl (2ug/kg), midazolam(0.1mg/kg), vecuronium (0.1 ～0.15mg/kg), diprivan(1.5～ 2.0mg/kg) and then tracheal cannula wereperformed to sustain the respiration with respirator. General anesthesia wasmaintained with continuously injecting diprivan and remifentanilaccording to the deepness of anesthesia. Vecuronium wasinterruptly injected for muscle relaxation. Patients in group Breceived epidural block(T7～ 8) before general anesthesia induction.The patients were injected with1% lindocaine 4ml. After 5min thepatients were injected with the mixed solution of 1% lindocaineand 0.375% bupicaine if without poisoning. At the same time,Ringer's solution or 6% Hens was given through the operation ofthoracic epidural cavity in order to preventing the decrease ofblood pressure. After thoracic epidural block, the patients weretreated as group A. Hemodynamics function, the levels of bloodglucose , catecholamine, respiratory and cardiac function wererecorded before anesthesia,at the time of endotracheal intubation,incision thoraces, exploring the thoracic cavity and endotrachealextubation, the PaO2, PaCO2 and PH were recorded at the time oftotal lung ventilation before incision thoraces, 15min and 30minafter one-lung ventilation after incision thoraces and 15min afterrecovery total lung ventilation to compare the two methods ofaneathesia.Results: MAP and HR of group B were more stable duringoperation than those of group A. BP of group B was lower than thatof group A during operation(P<0.05). The recovery time and theextubation time of group B were earlier than that of groupA(P<0.05). The plasma concentration of noradrenaline andadrenaline in group B were significantly lower than those in groupA. The anesthetic dosage used in group B was lower than that ingroup A during the operation.Conclusion: The interference on circulation system andthe stress respond of general anesthesia with epidural blockanesthesia are slighter than those of general anesthesia. Thegeneral anesthesia with epidural block anesthesia for thethoracotomy is batter than the general anesthesia. So the anesthesiamethod of general anesthesia with epidural block anesthesia isworth promoting.