腰麻-硬膜外联合麻醉与全身麻醉应用于妇科腹腔镜手术对比研究  

Comparison on combined spinal-epidural anesthesia and general anesthesia in gynecological laparoscopic operations

作　　者：廖惠花[1] 杨柳清[1] 莫坚[1] 

机构地区：[1]广东医学院附属医院麻醉科,广东省湛江524001

出　　处：《中国基层医药》2008年第3期388-389,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的比较腰麻-硬膜外联合麻醉（CSEA）与全身麻醉（GA）对妇科腹腔镜手术患者应激反应的影响。方法60例ASAI-Ⅱ级择期行妇科腹腔镜手术患者，分为腰麻-硬膜外联合麻醉与全身麻醉两组，每组30例，分别于麻醉前、麻醉后10min、气腹后10min、放气腹后10min取静脉血测定血糖和皮质醇浓度。结果两组患者年龄、体质量、手术时间、气腹时间、术毕清醒时间及各时间点的心率、氧分压、心电图检查、平均动脉压差异均无统计学意义（P〉0．05）。患者各时点的血糖、皮质醇浓度在两组间差异无统计学意义（P〉0．05）；除GA组血糖在气腹后10min明显低于麻醉前（P〈0．05），两组其余各时点血糖、皮质醇浓度与麻醉前比较差异无统计学意义（P〉0．05）。两组术后并发症发生率比较差异有统计学意义（P〈0．01）。结论CSEA和GA均可有效地抑制患者行妇科腹腔镜手术时的应激反应。Objective To compare the influences of combined spinal-epidural anesthesia（CSEA） and general anesthesia（GA） on patients who underwent laparoscopic gynecological operation. Methods A total of 60 patients of ASA I-Ⅱ, were divided into two groups ： the CSEA group and the general anesthesia group. Each group consisted of 30 patients. Glucose and cortisol levels were determined before anesthesia, 10 minutes after anesthesia, 10 minutes after pneumoperitoneum and 10 minutes after abdominal deflation. Results No significant differences existed be-tween the two groups on age, weight, operation time, pneumoperitoneum time, time to regain consciousness after operation, HR, SpO2 ,ECG and MABP（ P 〉 0.05 ）. No significant difference was found in cortisol level between two groups at various time points（P 〉 0.05）. In the general anesthesia group, glucose level at 10 minutes after pneu- moperitoneum was significantly lower than that before anesthesia（ P 〈 0.05 ）, but no significant difference was found in glucose level between the two groups at other time points（ P 〉 0.05）. At the same time,significant difference was found in postoperative complication rate between two groups（P 〈 0.01 ）. Conclasion Both CSEA and general anesthesia can effectively inhibit the patients＇ stress response in laparoscopic gynecological operation.

关 键 词：脊椎 硬膜外 麻醉 全身 腹腔镜检查 

分 类 号：R614[医药卫生—麻醉学]