RESUMO
Objecfive To observe the effect of high thoracic epidural block(HTEB)for preventing myocardial isehemia(MI)in pailents with coronary heart disease undergoing upper abdominal surgery. Methods Twenty patients undergoing upper abdominal surgery were randomly divided into two groups:M group(treated with HTEB,10 patients)was given both general anesthesia and HTEB and patient controlled epidural analgesia(PCEA)after operation and C group(without HTEB.10 patients)was given only general anesthesia and patient controlled intravenous analgesia(PCIA)after operation.The hemodynamies.ECG changes and serum troponin I and myoglobin and ereatine-kinase isozyme,the analgesia efficacy in M group were compared with those in C group.Results The hemodynamics in M group Was more stable than that in C group(P＜0.05).ComparedwithMgroup,thetotalnumberofST-segment depression attracheal extuba- tion moment and 10 hours after operation were significantly increased in C group(P＜0.05).The positive rates of Serum troponin I and creatine-kinase isozyme at 10 hours and 24 hours after operation in C group were much higherthan those in M group(P＜0.05).The an~tgesia effect in M group Was superiortothat in C group (P＜0.05)Conclusion The HTEB combined with general anesthesia may reduce mvocardial is- chemia in patients with coronary heart disease undergoing upper abdominal surgery.