Kuda T, Hara N, Kubota I, Chikama H, Motohiro A, Ichinose Y, Ohta M
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Dec;38(12):2376-9.
To clarify the prophylactic effect of epidural anesthesia with buprenorphine on postoperative pulmonary complications, the incidence of pulmonary complications after chest surgery was evaluated in 2 groups: the group that underwent epidural anesthesia, namely the test group, and the control group. Pulmonary complications were classified as follows: mild complications, sustained wheezing and/or small atelectasis-like shadows seen on chest x-rays. These improved by conventional methods except for bronchial toilet. Moderate complications included pneumonia and/or respiratory failure and/or atelectasis which needed bronchial toilet. There were 56 cases (58%) with no pulmonary complications in the control group and 89 cases (77%) in the test group. The number of patients with pulmonary complications were 40 (42%) in the control group and 27 (23%) in the test group, respectively (p less than 0.01). Those with mild or moderate complications were 25 (26%), 15 (16%) in the control group and 21 (18%), 6 (5%) in the test group, respectively. There was significant difference between no complication group and moderate complication group (p less than 0.01). These results show that epidural anesthesia is useful in preventing pulmonary complications after chest surgery.
为阐明布比卡因硬膜外麻醉对术后肺部并发症的预防作用，将胸部手术后肺部并发症的发生率在两组中进行评估：接受硬膜外麻醉的组，即试验组，以及对照组。肺部并发症分类如下：轻度并发症，表现为持续喘息和/或胸部X光片上可见小的肺不张样阴影。除支气管灌洗外，这些通过常规方法可改善。中度并发症包括肺炎和/或呼吸衰竭和/或需要支气管灌洗的肺不张。对照组有56例（58%）无肺部并发症，试验组有89例（77%）。对照组和试验组发生肺部并发症的患者数分别为40例（42%）和27例（23%）（p<0.01）。对照组轻度或中度并发症患者分别为25例（26%）、15例（16%），试验组分别为21例（18%）、6例（5%）。无并发症组和中度并发症组之间存在显著差异（p<0.01）。这些结果表明硬膜外麻醉有助于预防胸部手术后的肺部并发症。
