腹腔镜子宫切除术中不同麻醉方法对应激反应的影响

目的观察在硬膜外麻醉和全麻下腹腔镜子宫切除术中血浆肾上腺素（E）、去甲肾上腺素（NE）的变化。方法将40例拟行腹腔镜子宫切除术患者随机分成全麻（GA）组和硬膜外（EA）组，每组20例，监测麻醉前、气腹前10min、气腹后及放气后5min各时点血浆NE、E浓度。结果EA组术中各时点NE浓度无明显变化，气腹前及气腹后E明显增高（P〈0．05），术毕基本恢复（P〉0．05）；GA组气腹后NE和E均明显增高（P〈0．05），术毕E仍未恢复（P〈0．05）。结论两种麻醉方法术中均存在明显应激反应，硬膜外麻醉下施行腹腔镜子宫切除术中应激反应较全麻轻。

Effect of different methods of anaesthesia on the stress during laparoscopic hysterectomy

Objective To investigate the changes of plasma adrenaline(E) and norepinephrine(NE) during laparoscopic hysterectomy under epidural and general anesthesia.Methods Forty women undergoing laparoscopic hysterectomy were randomly divided into general anesthesia(group GA) and epidural anesthesia(group EA) with 20 cases each.The concentrations of E and NE were measured before anaesthesia(T_1),before(T_2) and after pneumoperitoneum(T_3),and after operations(T_4). Results In group EA,there was no obvious difference in the concentrations of NE among T_1,T_2,T_3 and T_4,but the concentrations of E were significantly increased at T_2 and T_3 compared with those at T_1(P<0.05).In group GA,the concentrations of NE at T_3 and E at T_3 and T_4 were significantly higher than those at T_1(P<0.05).Conclusion There was an obvious stress in both EA and GA,but the effect of EA was less than that of GA during laparoscopic hysterectomy.