全麻复合硬膜外麻醉在腹腔镜直肠癌根治术中应用的研究  

General combined with epidural anesthesia for laparoscopic-assisted rectectomy

作　　者：史斌 张蕾[2] 

机构地区：[1]山东临沂市肿瘤医院麻醉科,山东临沂276001 [2]山东临沂市人民医院超声室,山东临沂276001

出　　处：《中国现代普通外科进展》2006年第3期177-178,共2页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:评价全麻复合硬膜外麻醉在腹腔镜直肠癌根治术中的应用效果及安全性。方法:40例ASAⅠ～Ⅱ级择期行腹腔镜直肠癌根治术的病人,随机分为A组和B组各20例。A组为全麻复合硬膜外麻醉组,B组为单纯全麻组,分别观察两组病人手术期血流动力学变化、血气变化及全麻药用量。结果:两组病人手术期各时段HR、MAP变化A组均较B组轻且平稳;两组病人血气分析PaO2、HCO3均明显高于术前(P<0.01),但两组无明显差异;A组全麻药用量明显小于B组(P<0.01)。结论:全麻复合硬膜外麻醉用于腹腔镜直肠癌根治术较单纯应用全身麻醉,全麻药用量明显减少,循环呼吸功能平稳,且便于术后镇痛。Objective：To evaluate the safety and efficacy of laparoscopic-assisted rectectomy under combined general and epidural anesthesia.Methods：Forty ASA Ⅰ-Ⅱ patients scheduled for selective laparoscopic-assisted recteotomy were rendomly divided into two groups：sroup A and group B. Group A received combined general and epidural enesthesla end Stoup B received general anesthesia only. Hemodynamics changes,PaO2 HCO2^- and anesthetic doses were observed preoperatlon ,perioperation and Postoperation. Results： The changes of HR, MAP In Stoup A were lower then that of group B. PaO2, HCO2 were signiflcantly higher then that of precperation（P〈0. 01） ,but there were no signiflcent difference between the two groups. The anesthetic doses of group A were Significently lower than that of gorup B（P〈0.01）. Conclusion：Comparing to general enesthesla, combined general and epidural anesthesia can significantly reduce the anesthetic doses, use PECA conveniently and have no sisnificant reverse effect on circulation and respiratory. So combined general end epidural enesthesla is the best choice for laparosooPlC-assisted rectectomy.

关 键 词：麻醉 全身 麻醉 硬膜外 腹腔镜 结直肠外科手术 

分 类 号：R614.2[医药卫生—麻醉学] R614.42[医药卫生—外科学]