全麻复合硬膜外麻醉与单纯全麻在腹腔镜胆囊切除术中应用的比较  

Comparison of general anesthesia combined with epidural anesthesia and general anesthesia in laparoscopic cholecystectomy

作　　者：高满海[1] 庞海[1] 魏巍[1] 包彦龙 GAO Manhai;PANG Hai;WEI Wei;BAO Yanlong(Department of Anesthesiology,The First Affiliated Hospital of Inner Mongolia University of Science and Technology,Baotou 014010,China)

机构地区：[1]内蒙古科技大学第一附属医院麻醉科,内蒙古包头014010

出　　处：《包头医学院学报》2020年第10期18-19,54,共3页Journal of Baotou Medical College

摘　　要：目的:比较全麻复合硬膜外麻醉与单纯全麻在腹腔镜胆囊切除术中的应用。方法:100例腹腔镜胆囊切除术患者随机分为两组,即:全麻复合硬膜外麻醉组(联合组)和单纯全麻组(对照组),联合组是在患者T9-10实施硬膜外穿刺和全麻诱导后插入喉罩,对照组是全麻诱导后插入喉罩,每组50例,监测MAP、HR、SpO2、ECG,分别于插入喉罩时、插入喉罩后10min、拔出喉罩时3个时刻记录MAP、HR。结果:与对照组相比较,联合组MAP、HR在插入喉罩时、拔出喉罩时低于对照组(P<0.05),差异有统计学意义,联合组在插入喉罩后10 min低于对照组(P<0.01),差异有统计学意义。用药量方面对比,联合组在用药量低于对照组。镇痛方面,硬膜外术后镇痛效果确切,不良反应发生率低。结论:全麻复合硬膜外麻醉在腹腔镜胆囊切除术中能较好地控制应激反应;对术中、术后血流动力学的稳定造成的不良影响小;病人苏醒快;术后镇痛效果好等优点。Objective:To compare the application of general anesthesia combined with epidural anesthesia and simple general anesthesia in laparoscopic cholecystectomy.Methods:100 patients with laparoscopic cholecystectomy were randomly divided into two groups,namely,the general anesthesia combined with epidural anesthesia group(the combination group)and pure general anesthesia group(the control group).The combination group was implemented in T9-10 of patients with epidural puncture and a laryngeal mask was inserted after induction of general anesthesia,while the control group was inserted after induction of general anesthesia of laryngeal mask,50 cases in each group.MAP,HR,SpO2 and ECG were monitored.MAP and HR were recorded at the time of insertion,10 min after insertion and at the time of extraction of the laryngeal mask,respectively.Results:Compared with the control group,MAP and HR in the combined group were lower than those in the control group when the laryngeal mask was inserted and the laryngeal mask was removed(P<0.05),and the difference was statistically significant.MAP and HR in the combined group were lower than those in the control group at 10min after laryngeal mask airway insertion(P<0.01),and the difference was statistically significant.The dosage of the combined group was lower than that of the control group.In terms of analgesia,the effect of epidural postoperative analgesia was definite,and the incidence of adverse reactions was low.Conclusion:General anesthesia combined with epidural anesthesia can better control stress response well in laparoscopic cholecystectomy.It has little adverse effect on the hemodynamic stability during and after operation.The patient awakes quickly;postoperative analgesic effect is good.

关 键 词：全麻复合硬膜外麻醉 全麻 腹腔镜胆囊切除术 

分 类 号：R61[医药卫生—外科学]