Preemptive Analgesia Of Endotracheal Anesthesia Combined With Epidural Anesthesia During The Operation On Upper Abdominal Region

Objective To investigate the effect of postoperative analgesia with differential time of epidural medication,differential derivation and maintained medicine of general anesthesia,during the operation on upper abdominal region with endotracheal anesthesia combined with epidural anesthesia.Method 120 cases were seperated to three groups(A,B,C)in random,each group had 40 cases.Group A: influx mixed liquor of 2% Lidocaine and 0.25%Tetracaine 8 ml to cavitas epiduralis through T8-9;after that influx Tramadol to cavitas epiduralis,1 mg/kg;revulsive of general anesthesia was Fentanyl 4ug/kg,Propofol 1-2 mg/kg,Midazolam 0.02-0.04 mg/kg,Vecuronium Bromide 0.1 mg/kg.Group B:during the derivation and maintain of general anesthesia,Fentanyl was not used,replaced by Lidocaine 1 mg/kg,others were same to group A.Group C:after epidural puncturation through T8-9,then start the general anesthesia,samed to group A,slivered skin,90 min later,influx mixed liquor of 2% Lidocaine and 0.25%Tetracaine 8 ml to cavitas epiduralis through T8-9;after that influx Tramadol to cavitas epiduralis,1 mg/kg;to observe the difference of the hemodynamics before and after the skin slivered seperatedly,to observe indexes included VAS score,the dosis of pain-killer and postoperative nausea,emesis,dysphoria,itch of skin etal,4,8,24,48 hours after the operation.Result Group A: the dosis of pain-killer was least,the effect of analgesia was best.Group B and C had not obviouse difference in VAS score,the dosis of pain-killer and secondary action.Conclusion during the operation on upper abdominal region with endotracheal anesthesia combined with epidural anesthesia,epidural anesthesia and Fentanyl were used at the same time,the effect of postoperative analgesia was best.