平卧位硬膜外麻醉行腹腔镜胆囊切除术的临床体会

目的:探讨在平卧位硬膜外麻醉下行腹腔镜胆囊切除术的手术方法及临床价值。方法:回顾分析2002年1月至2010年12月为3 541例患者采用平卧位硬膜外麻醉下行腹腔镜胆囊切除术的临床资料。结果:104例改为气管插管全身麻醉,13例改变体位,35例中转开腹。术中胆管损伤4例,无一例下肢深静脉血栓形成,手术时间平均35 min。结论:采用平卧位连续硬膜外麻醉行腹腔镜胆囊切除术是可行的,减少了术中患者生命体征的波动及深静脉血栓形成的风险,有效预防了周围神经损伤的发生,适于在基层医院推广应用。

The clinical experiences of laparoscopic cholecystectomy under epidural anesthesia in supine position

Objective: To investigate the surgical methods and clinical significance of laparoscopic cholecystectomy under epidural anesthesia in the supine position.Methods: The clinical data of 3 541 cases who underwent laparoscopic cholecystectomy under epidural anesthesia in supine position from Jan.2002 to Dec.2010 were retrospectively analyzed.Results: General anesthesia was converted to in 104 cases,position changed in 13 cases and laparotomy was converted to in 35 cases.Bile duct injury occurred in four cases.No deep venous thrombosis occurred.The mean operative time was 35 min.Conclusions: Laparoscopic cholecystectomy under epidural anesthesia in supine position is feasible,reduces the fluctuations of vital signs and risks of deep venous thrombosis,prevents peripheral nerve injury effectively,and is suitable to popularize in primary hospitals.