腹腔镜胆囊切除术硬膜外阻滞复合静脉全麻效果分析

目的探讨硬膜外阻滞复合全麻用于腹腔镜胆囊切除手术的可行性、安全性,以及与插管全麻对比,麻醉诱导前、后,气腹时,苏醒时病人的血液动力学变化。方法50例腹腔镜胆囊切除手术病人,随机分为A组(硬膜外阻滞复合静脉全麻组)、B组(插管全麻组),记录诱导前、后,气腹即时,气腹后10min,术中及苏醒时HR、MAB、SPO2。结果①SPO2变化无显著性差异(p>0.05)。②HR、MAP变化a、与麻醉诱导前比较,诱导后明显下降,有显著性差异(p<0.05),与诱导前比较,气腹时,明显升高,有显著性差异(p<0.05)而组间无显著性差异。b、苏醒前,与A组比较,B组明显升高,有显著性差异(p<0.05)。结论硬膜阻滞复合静脉全麻用于腹腔镜胆囊切除手术更有利于血液动力学的稳定,是安全的,可行的。

OBSERVATION ON THE EBCVGA APPLIED ON LC

Objective To study the feasibility and safety of the epidural block combining with the venous general anesthesia (EBCVGA) applied on patients who are conducted the laparoscopic cholecystectomy (LC) and then comparing the hemodynamic changes before and after anesthesia induction, after pneumoperitoneum and before awaking with those in intubation general anesthesia. Method A total of 50 cases of LC patients were divided into Group A (EBCVGA group) and Group B (intubation general anesthesia group). The HR, MAP and SPO2 before and after anesthesia induction, in immediate pneumoperitoneum and 10 minutes after pneumoperitoneum and before awaking were respectively recorded. Results I. No significant differences in SPO_2 (p>0.05). II. Changes in HR and MAP: a. Comparing with those before anesthesia induction, these two indexes had obvious drop after induction (p<0.05); when in pneumoperitoneum, these two indexes greatly increased (p<0.05), which had significant differences, but no obvious differences between the two groups. b. Before awaking: Comparing with those in Group A, these two indexes in Group B obviously enhanced (p<0.05). Conclusion The EBCVGA is more helpful for patients who are conducted the LC in their hemodynamic stability, which is safe and feasible.