硬膜外阻滞复合全麻在老年病人腹腔镜胆囊手术的应用

目的探讨硬膜外阻滞复合全麻在老年病人腹腔镜胆囊手术的应用。方法ASAⅠ-Ⅱ级60～94岁胆囊手术患者120例，分成单纯全麻组（Q组，n=60），和硬膜外阻滞复合全麻组（Y组，n=60）。监测SBP、DBP、HR、PETCO2、SpO2、气道压，记录血流动力学参数，术中所用血管活性药病例数及麻醉药剂量。结果Y组麻醉诱导、气管插管、切皮时、拔气管导管时SBP、DBP、HR低于Q组，血流动力学稳定，所用麻醉药少于Q组。结论硬膜外阻滞能不同程度抑制麻醉手术所致的应激反应，硬膜外阻滞复合全麻在老年病人腹腔镜胆囊手术的应用是安全的、可行的、有益的。

The Application of Combined General-epidural-anesthesia in Laparoscopic Cholecystectomy of Senile Patients

Objective To discuss the application of combined general - epidural - anesthesia in laparoscopic cholecystectomy of senile pa- tients. Methods 120 senile cases to be operated on of gallbladder at the age from 60 to 94 years old, whose ASA degrees were from Degree Ⅰ to Degree Ⅱ, were divided into 2 groups ： Group Q （ general anesthesia） and Group Y （ combined general - epidural - anesthesia） , 60 in each; SBP, DBP HR, PETCO2, SpO2 and airway pressure were monitored, the bemodynamie parameters, the case number with vasoactive drug administration in operation and anesthetic dosage were recorded. Result SBP, DBP and HR of the patients in Group Y with hemodynamic stability at the time of anesthesia induction, tracheal intubation, skin incision and tracheal catheter removing were lower than those of the patients in Group Q, and their anesthetic dosage was smaller than that in Group Q. Conclusions Epidural block can inhibit at certain degree the stress response to anesthesia; the application of combined general- epidural- anesthesia in laparoseopie choleeystectomy of senile patients is safe, feasible and useful.