妇科腹腔镜手术全麻复合硬膜外阻滞效果观察

目的探讨硬膜外阻滞复合全麻用于妇科腹腔镜手术的可行性和安全性。方法选择妇科腹腔镜手术患者72例，随机分为两组，全麻＋硬膜外组（Ⅰ组）和全麻组（Ⅱ组），术中连续监测血压（Bp）、二氧化碳饱和度（HR）、心率（SpO2）变化。结果两组HR、SBP及DBP在诱导后较麻醉前均有降低，两组比较差异有统计学意义（P〈0．05）。Ⅱ组气管插管时心率较Ⅰ组明显增快（P〈0．05），术中、气管拔管时Ⅰ组HR、SBP及DBP明显低于Ⅱ组，两组比较差异有统计学意义（P〈0．05）。I组在睁眼时间、拔管时间及切题回答时间方面明显短于Ⅱ组，两组比较差异均有统计学意义（P〈0．05）。烦躁及寒颤发生率Ⅱ组明显高于Ⅰ组，两组比较差异均有统计学意义（P〈0．05）。结论妇科腹腔镜手术采用全麻复合硬膜外阻滞麻醉效果确切，不良反应少。

Study on Effect of Epidural Block with General Anesthesia in Gynecologic Laparoscopic Operation

Objective To explore the feasibility and safety of epidural block with general anesthesia in gynecologic laparoscopic operation.Methods 72 patients were divided randomly into two groups:the epidural block with general anesthesia group(Ⅰ group)and the general anesthesia(Ⅱgroup).All patients were monitored continuously for the changes of Bp,HR and SpO2 during the operation.Results The HR,SBP and DBP of two groups after inductions were lower than those before anesthesia,and there were significant differences(P＜0.05).The HR of Ⅱ group was quicker than that of Ⅰ group in the time of lifesaver(P＜0.05).The HR,SBP and DBP of Ⅰ group were lower than that of Ⅱ group in the time of operation and extubation(P＜0.05).The times of eyes open,extubation and answering the question correctly in Ⅰ group were shorter than those in Ⅱ group,and there were significant differences(P＜0.05).And the incidence rates of restlessness and shivering in Ⅰ group were higher than those in Ⅱ group,and there were significant differences,(P＜0.05).Conclusion Epidural block with general anesthesia in gynecologic laparoscopic operation is effective,and the adverse effects is fewer.