胸段硬膜外麻醉的研究进展及应用

硬膜外应用局麻药为手术提供麻醉与镇痛,同时胸段硬膜外麻醉与镇痛也被广泛应用于心脏,大血管,胸部和腹部的手术中.它不仅可以加快病人麻醉后的苏醒,而且可以提供很好的术后镇痛.除了上述优点,许多基础及临床研究发现硬膜外麻醉还有许多其它方面的作用,如:减轻神经内分泌系统的应激反应、减少围术期并发症的发生,以及通过暂时性的阻滞胸交感神经提供心肺及胃肠道的保护作用,改善免疫和凝血功能.本文就近年来胸段硬膜外麻醉应用及研究进展作一综述.

Research Progress and Application of Thoracic Epidural Anesthesia

The epidural administration of local anaesthetic agents was primarily designed to provide perioperative anaesthesia and analgesia.Meanwhile,thoracic epidural anaesthsia（TEA） and analgesia are practiced extensively by many anaesthesiologists for cardiac,thoracic and abdominal surgery.Not only can it speed up awakening after anesthesia,and can provide good postoperstive analgesia.However,many experimental and clinical studies have shown that epidural anaesthesia may have effects far beyond pain relief.Regional anaesthesia may decrease the neuroendocrine stress response and therefore reduce the number of perioperative complications.Furthermore,transient thoracic sympathectomy by TEA has been suggested to offer protective cardiac,pulmonary and gastrointestinal effects as well as positive immunological and coagulation properties.The technique is thus thought to have a significant impact on the outcome of major surgical procedures.This review will focus on research progress and application of thoracic epidural anesthesia.