腰硬联合阻滞复合喉罩麻醉与气管插管全麻在腹腔镜阑尾炎手术中的应用对比

目的：对比腰麻联合硬膜外阻滞（combined spinal and epidural anesthesia, CSEA）复合喉罩麻醉与气管插管全身麻醉在腹腔镜阑尾切除术（laparoscopic appendectomy，LA）中的麻醉效果。方法：选择240例ASA分级I或Ⅱ级的LA患者，随机分为两组，每组120例，复合组采用CSEA复合喉罩通气，全麻组采用静脉复合插管全麻。记录两组患者MAP、HR、PETCO2、镇痛情况、血糖、麻醉费用等相关指标。结果：全麻组术中血糖高于复合组（P〈0．05）；复合麻醉组镇痛满意度更高，麻醉费用更低。结论：与单纯全麻相比，CSEA复合喉罩可更好地抑制IA术中患者的应激反应，全麻药物用量减少，术后镇痛效果好，费用低，是基层医院LA术中麻醉的理想选择。

The comparison of the efficacy between combined spinal and epidural anesthesia with laryngeal mask anesthesia and general anesthesia with tracheal intubation in laparoscopic appendectomy

Objective：To compare the efficacy of combined spinal and epidural anesthesia （CSEA） with laryngeal mask anesthesia and general anesthesia with tracheal intubation in laparoscopic appendectomy （LA）. Methods：Two hundred and forty patients （ASA I - lI ） who accepted LA were randomly divided into combined anesthesia group （n = 120） and general anesthesia group （ n = 120）. Combined anesthesia group underwent CSEA and laryngeal mask anesthesia, while general anesthesia group underwent general anesthesia with tracheal intubation only. Mean artery pressure （MAP）, heart rate （HR）, PET CO2, analgesic effect, blood glucose, anesthetic cost and so on were recorded. Results：Blood glucose and anesthetic cost in combined anesthesia group were lower than those in general anesthesia group （P 〈 0.05）. Analgesic efficacy of combined group was better than that of general anesthesia group. Conclusions：Compared with pure general anesthesia, CSEA with laryngeal mask can better inhibit stress reaction of LA, reduce the dosage of anesthetic drugs and has good effect of postoperative analgesia with low cost, so it can be the ideal choice of anesthesia for LA in primary hospitals.