腹腔镜手术麻醉方法的安全性评价

目的评价腹腔镜手术中全身麻醉与硬膜外麻醉的安全性。方法检索CBMdisc光盘数据库、MEDLINE数据库及Cochrane图书馆麻醉学专业组数据库,筛选符合纳入标准的1997-2007年公开发表的文献15篇。纳入标准原始文献的类型为前瞻性随机对照研究或设计良好的非随机对照研究。通过各研究间的异质性分析及固定效应模型、随机效应模型两种模型的综合分析得出生存结果,统计学方法采用Cochrane协作网提供的软件包RevMan5.0。结果纳入15个研究分析,全身麻醉与硬膜外麻醉的各项指标异质性Q检验显示差异无统计学意义,加权均数差值〉0,P=0.11～0.80〉0.05。结论通过Meta分析的结果表明,硬膜外麻醉与全身麻醉应用于腹腔镜手术同样安全可靠。

The Evidence-Based Evaluation to the Safety of Anesthesia Ways in Laparoscopic Surgery

Objective To evaluate safety of general anesthesia and epidural anesthesia in laparoscopic surgery.Methods We searched for randomized trials（published from Jan.1997 to Dec.2007） in anesthesiology that compared adjuvant general anesthesia or/and epidural anesthesia alone through CBMdisc,MEDLINE,and Cochrane Anesthesiology Group＇s Specialised Register Central.Fifteen domestic public documents were chosen for analysis.Results for survival were combined with fixed and random effects models and between-study heterogeneity was estimated.RevMan5.0 software was applied to process data.Results In fifteen studies,the vital signs of general anesthesia demonstrated no statistically significant compared with epidural anesthesia（WMD〉0,P=0.11～0.80〉0.05）.Conclusion This meta-analysis confirms that the safety and reliability of general anesthesia are the same as epidural anesthesia in laparoscopic surgery.