全身麻醉联合硬膜外阻滞在老年腹腔镜结肠癌根治术中的应用价值  

The Value of General Anesthesia Combined with Epidural Block Applied in Senior Laparoscopic Radical Procedure for Colonic Cancer

作　　者：李永辉 张瑞波[1] 鲁文静[1] LI Yong-hui;ZHANG Rui-bo;LU Wen-jing(The 3rd People's Hospital of Zhengzhou City,Zhengzhou,Henan 450000)

机构地区：[1]郑州市第三人民医院,河南郑州450000

出　　处：《中国肛肠病杂志》2020年第8期10-11,共2页Chinese Journal of Coloproctology

摘　　要：为探讨全身麻醉联合硬膜外阻滞在老年腹腔镜结肠癌根治术中的应用价值,将2018年3月至2019年8月于我院肿瘤科就诊且拟行腹腔镜结肠癌根治术治疗的100例老年患者随机分为观察组和对照组,各50例。对照组于全身麻醉下手术,观察组于全麻联合硬膜外阻滞下手术。比较2组围手术期指标(手术时间、麻醉时间、术中出血量、补液量、拔管时间、恢复自主呼吸时间、苏醒时间)、麻醉相关指标(瑞芬太尼用量、丙泊酚用量),以及术后4h、24h、48h认知功能障碍(POCD)发生情况。结果显示,2组患者手术时间、麻醉时间、术中出血量、补液量、拔管时间、恢复自主呼吸时间、苏醒时间、瑞芬太尼用量、术后48hPOCD发生率比较差异均无统计学意义,P>0.05;但观察组丙泊酚用量明显少于对照组,术后4h和24hPOCD发生率明显低于对照组,P<0.05。结果表明,与单纯全身麻醉相比,联合硬膜外阻滞对老年患者进行腹腔镜结肠癌根治术,可降低丙泊酚用量及术后POCD发生率,安全性更好。This study was to explore the application value of general anesthesia and epidural block during senior laparoscopic radical procedure(LRP)for colon cancer,randomly divided 100senior patients to be subject to the procedure in authors'hospital(2018-03-2019-08)into control group(50cases,only general anesthesia when operating)and observation group(50cases,general anesthesia plus epidural block);then compared:1)perioperative norms:operating time,anesthesia time,intraoperative bleeding volume,infusion volume,extubating time,the time for automomic respiratory recovered,and emergence time;2)relevant norms of anesthesia:remifentanil dosage and propofol dosage;3)postoperative cognitive dysfunction(POCD):4,24and 48hrs after surgery,between the four groups.As results,except for propofol dosage,and the incidence of POCD 4hrs and 24hrs after surgery in observation group being significantly less and lower than those in control group(all,P<0.05);in rest above indexes there were no significant differences between the two groups(all,P>0.05).Results show that compared with only general anesthesia,combined with epidural block amidst LRP can reduce propofol dosage and postoperative POCD incidence,and with more higher safety.

关 键 词：全麻联合硬膜外阻滞 老年腹腔镜结肠癌根治术 认知功能障碍 

分 类 号：R614[医药卫生—麻醉学] R735.35[医药卫生—外科学]