探讨硬膜外阻滞复合全身麻醉对腹腔镜子宫切除术围术期疼痛介质的影响  

Effects of epidural block combined with general anesthesia on pain mediators in patients undergoing laparoscopic hysterectomy

作　　者：孟红伟[1] MENG Hong-wei(Operating Room,Anshan Women’s and Children’s Hospital,Anshan 114000,China)

机构地区：[1]鞍山市妇儿医院手术室,114000

出　　处：《中国实用医药》2021年第32期76-78,共3页China Practical Medicine

摘　　要：目的分析腹腔镜子宫切除术患者采用硬膜外阻滞复合全身麻醉对疼痛介质的影响。方法86例腹腔镜子宫切除术患者,以随机单盲法分为观察组与对照组,每组43例。对照组采用全身麻醉,观察组采用硬膜外阻滞联合全身麻醉。比较两组不同时间疼痛介质水平、麻醉指标、不良反应发生情况。结果麻醉后6、12、24 h,观察组前列腺素E2、5-羟色胺、P物质水平均低于对照组,差异有统计学意义(P<0.05)。观察组自主呼吸恢复时间(3.3±2.1)min、苏醒时间(6.6±4.3)min、导管拔除时间(9.4±4.1)min均短于对照组的(4.3±2.3)、(8.6±4.6)、(12.4±4.3)min,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论硬膜外阻滞复合全身麻醉方式在腹腔镜子宫切除术中应用优势明显,能够减少疼痛介质的分泌量,而且术后苏醒较快。Objective To analyze the effects of epidural block combined with general anesthesia on pain mediators in patients undergoing laparoscopic hysterectomy.Methods A total of 86 patients undergoing laparoscopic hysterectomy were randomly divided into observation group and control group,with 43 cases in each group.The control group received general anesthesia,and the observation group received epidural block combined with general anesthesia.The pain mediators at different time points,anesthesia indicators,and the occurrence of adverse reactions were compared between the two groups.Results At 6,12,and 24 h after anesthesia,prostaglandin E2,5-hydroxytryptamine,and substance P in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The spontaneous breathing recovery time(3.3±2.1)min,awakening time(6.6±4.3)min,and catheter removal time(9.4±4.1)min in the observation group were shorter than(4.3±2.3),(8.6±4.6)and(12.4±4.3)min in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Epidural block in combination with general anesthesia in laparoscopic hysterectomy has significant advantages in terms of reduced secretion of pain mediators and faster postoperative awakening.

关 键 词：腹腔镜子宫切除术 全身麻醉 硬膜外阻滞 疼痛介质 

分 类 号：R614[医药卫生—麻醉学]