两种硬膜外阻滞麻醉对腹腔镜手术血气分析的影响

目的:探讨单点和两点连续硬膜外阻滞麻醉方法对下腹部、盆腔腹腔镜手术血气分析的影响。方法:随机选择腹腔镜下行下腹部、盆腔手术患者46例平均分为A、B两组,A组实施L1~2间隙单点连续硬膜外阻滞麻醉,B组实施T9~10、L2~3两点间隙连续硬膜外阻滞麻醉,并作术中SpO2、PaO2、PaCO2、PETCO2连续监测。结果:A组SpO2、PaO2、PaCO2、PETCO2和B组PaCO2、PETCO2与麻醉前比较,均有显著性差异(P<0.05)。组间比较SpO2、PaO2,有显著性差异(P<0.05),B组PaCO2、PETCO2比A组略低,但P>0.05无显著性差异。结论:腹腔镜下行下腹部、盆腔手术时,两点连续硬膜外阻滞麻醉对呼吸功能的影响小,与单点连续硬膜外阻滞麻醉相比更值得临床应用。

Effection of two kinds of epidural anesthesia on blood-gas analysis of laparoscopic surgery

Objective:To explore the effection of one interspace and two interspaces epidural block on the blood-gas analysis of laparoscopic surgery in lower-abdomen and pelvic cavity.Methods:46 patients undergoing laparoscopic surgery in lower-abdomen and pelvic cavity were randomly devided into two groups with A and B,group A received L_(1-2) while group B received T_(9-10)、L_(2-3) interspaces contonious epidural anathesia.The data of SpO_2,PaO_2,PaCO_2 and P_(ET)CO_2 were recorded in the operation.Results:There were statistically significant differences between SpO_2,PaO_2,PaCO_2,P_(ET)CO_2 of group A and PaCO_2,P_(ET)CO_2 of group B compared with pre-operation.Between the two groups,significant differences of SpO_2 and PaO_2 was observed,the data of PaCO_2 and P_(ET)CO_2 were lower than group A,but there were no significant differences.Conclusions:Two interspaces epidural block has a less effection on the breath of laparoscopic surgery in lower abdomen and pelvic cavity,so it has more advantanges than one interspace block.