Harti A, Abassi O, Benabdenbi F, Yamani K, Benchakroun Y, Benaguida M
Département d'anesthésie-réanimation, Centre hospitalier et universitaire Ibnou-Rochd, Casablanca.
Agressologie. 1991;32(4):250-1.
Cervical peridural anesthesia was associated to a general anesthesia with controlled ventilation in ten patients undergoing laryngectomy for cancer. All the patients (middle age 57 years) suffered chronic bronchopneumopathy. The cervical peridural approach is realized by puncture at the level C6-C7 with setting of a peridural catheter. After a test dose, a total volume of 18 ml of bupivacaïne at 0.33% is injected. Reinjections of nine ml of the anesthetic solution are realized after a mean delay 200 min. After induction with thiopental and pancuronium bromide, narcosis is maintained by N2O/O2, 0.5/0.5 associated to 0.5% halothane. The mean operating time was four hours and ten minutes. The anesthetic block obtained stretches from C2 to D4, after a mean delay 22 +/- 7 min. Analgesia is satisfying. Little changes occurs in hemodynamic state, except an almost constant bradycardia. Bleeding stay in range of laryngectomies. The awakening is immediate; the post-operative evolution is simple. No complication tied to the anesthesia has been observed.
10例因癌症行喉切除术的患者接受了颈段硬膜外麻醉联合控制通气的全身麻醉。所有患者（平均年龄57岁）均患有慢性支气管肺炎。颈段硬膜外穿刺在C6 - C7水平进行，并置入硬膜外导管。给予试验剂量后，注入总量为18 ml的0.33%布比卡因。平均200分钟后再次注入9 ml麻醉溶液。用硫喷妥钠和溴化潘库溴铵诱导后，通过N2O/O2（0.5/0.5）联合0.5%氟烷维持麻醉。平均手术时间为4小时10分钟。平均延迟22±7分钟后，获得的麻醉阻滞范围从C2至D4。镇痛效果良好。除几乎持续的心动过缓外，血流动力学状态变化不大。出血量在喉切除术的范围内。苏醒迅速；术后恢复过程顺利。未观察到与麻醉相关的并发症。
