Effects of elevation epidural block with 0.2% ropivacaine on lung fuction / 解放军医学杂志

ABSTRACT

Objective To evalue the effects of elevation epidural block with 0.2% ropivacaine on lung function. Methods fifty ASA Ⅰ-Ⅱ patients undergoing elective radical mastectomy were anesthetized with method of epidural block .T 2-3 or T 3-4 were selected as puncture site. A catheter was inserted into the epidural space in a cephalad direction for 3-4cm. Nasal catheter oxygen inhalation was used in routine method. A loading dose of 0.2% Ropivacaine 15-20ml was given after a test dose of 1% lidocaine 5ml or 0.2% ropivacaine 5ml. Generally, the first dosage was at 25-30ml. The anesthesia effect, segments of block were measured and heart rates (HR),blood pressure (BP), blood oxygen saturation(SpO 2) were assessed before anesthesia, after anesthesia and at the end of surgery, meanwhile the breathing frequency, minute ventilation and maximal voluntary ventilation(MVV) were monitored. Blood gas, lactic acid and serum glucose were detected from 25 of the total case before and after anesthesia. Levels of sense obstacle and movement of bilateral upper limbs were recorded after operation. Results All 50 patients but one were finely anesthetized by elevation epidural block with 0.2% ropivacaine. Among them 39(78%) patients were blocked at C 5-T 8. No significant difference existed before and after anesthesia on breathing frequency, minute ventilation and maximal voluntary ventilation, and the values of blood gas in all those patients analysed were normal. Over 20% of decline on BP and obvious reduction on HR were found in 8 patients after anesthesia (P