全麻复合硬膜外阻滞抑制老年患者腹腔镜胆囊切除术的应激反应

目的: 比较全麻复合硬膜外阻滞和单纯全麻用于老年患者腹腔镜胆囊切除术(LC)时应激反应的差异。方法: 老年患者40例,随机分为两组.Ⅰ组为单纯全麻,Ⅱ组为全麻复合硬膜外阻滞.分别测定不同时段的皮质醇、血糖、SBP、HR等。结果: Ⅰ组的皮质醇、血糖、SBP在二氧化碳气腹后到排放二氧化碳后明显高于Ⅱ组(P<0.05~P<0.01).HR仅在排放二氧化碳后明显高于Ⅱ组(P<0.05)。结论: 全麻复合硬膜外阻滞可有效抑制应激反应,从而对老年患者的腹腔镜胆囊切除术提供了一定的安全性。

Combined general-epidural anesthesia inhibits stress response of the aged undergoing laparoscopic cholecystectomy

Objective: To compare the difference of the stress response of aged patients receiving laparoscopic cholecystectomy(LC) under general anesthesia or combined general-epidural anesthesia.Methods: Forty patients were divided randomly into two groups:groupⅠ(general anesthesia) and group Ⅱ(combined general-epidural anesthesia).The plasma concentration of cortisone,glucose,SBP and HR were measured in difference periods.Results: Cortisone,glucose and SBP were significantly higher in group Ⅰ than in group Ⅱ from 15 min after pneumoperitonium to 15 min after discharging CO₂(P<0.05 to P<0.01).HR was significantly higher in group Ⅰ than in group Ⅱ 15 min after discharging CO₂(P<0.05).Conclusions: Combined general-epidural anesthesia can effectively inhibit the stress response,which ensures the safety of aged patients undergoing laparoscopy cholecystectomy.