全麻复合硬膜外麻醉对前列腺癌患者术中肌松剂使用量及应激反应的影响  

Effect of general anesthesia combined with epidural anesthesia on dosage of muscle relaxant and stress response in patients with prostate cancer during operation

作　　者：刘林芝 黎伟 LIU Linzhi;LI Wei(Department of Anesthesiology,Chang’an Hospital,Xi’an 710016,China)

机构地区：[1]长安医院麻醉科,陕西西安710016

出　　处：《陕西医学杂志》2023年第4期441-444,共4页Shaanxi Medical Journal

基　　金：西安市卫生和计划生育委员会卫生科研人才项目(J20190307)。

摘　　要：目的:探究了全麻复合硬膜外麻醉对前列腺癌患者术中肌松剂使用量及应激反应的影响。方法:纳入收治的前列腺癌患者104例,随机分为全麻组和硬膜外麻醉组,各52例。比较全麻组和硬膜外麻醉组的睁眼时间、手术时间、丙泊酚用量、顺阿曲库铵使用量。比较全麻组和硬膜外麻醉组患者麻醉前(T1)、切皮时(T2)以及手术完成时(T3)的血流动力学指标。比较全麻组和硬膜外麻醉组患者术前、术后1 d的应激反应指标和炎症因子水平。结果:全麻组睁眼时间、丙泊酚用量、顺阿曲库铵使用量均高于硬膜外麻醉组,比较差异具有统计学意义(均P<0.05)。与T1相比,T2和T3时,两组的收缩压、血氧饱和度(SpO_(2))均下降,心率升高,且硬膜外麻醉组收缩压、心率、SpO_(2)水平均明显优于全麻组,比较差异具有统计学意义(均P<0.05)。术后1 d,两组的皮质醇(COR)、过氧化氢酶(CAT)、前列腺素E_(2)(PGE_(2))水平均明显高于术前,其中硬膜外麻醉组的COR、CAT、PGE_(2)水平明显低于全麻组,差异具有统计学意义(均P<0.05)。术后1 d,两组的白细胞介素-6(IL-6)、IL-8、降钙素原(PCT)水平均明显高于术前,其中硬膜外麻醉组的IL-6、IL-8、PCT水平明显低于全麻组,差异具有统计学意义(均P<0.05)。结论:全麻复合硬膜外麻醉能够有效降低前列癌患者术中肌松剂使用量,改善血流动力学,抑制应激反应和炎症因子释放。Objective:To study the effect of general anesthesia combined with epidural anesthesia on the dosage of muscle relaxant and stress response in patients with prostate cancer during operation.Methods:A total of 104 patients with prostate cancer were randomly divided into general anesthesia group and epidural anesthesia group,52 patients each.The eye opening time,operation time,propofol dosage and cisatracurium dosage were compared between two groups.The hemodynamic indexes before anesthesia(T1),at the time of skin incision(T2)and at the time when operation completed(T3)were compared between two groups.The levels of stress response indexes and inflammatory factors were compared between two groups at preoperation and 1 day after operation.Results:The eye opening time,propofol dosage and cisatracurium dosage in the general anesthesia group were significantly higher than those in the epidural anesthesia group(all P<0.05).Compared with T1,systolic blood pressure and SpO _(2) decreased and heart rate increased in the two groups at T2 and T3,and the levels of systolic blood pressure,heart rate and SpO _(2) in the epidural anesthesia group were significantly higher than those in the general anesthesia group(all P<0.05).On the first day after operation,the levels of COR,CAT and PGE _(2) in the two groups were significantly higher than those before operation,and the levels of COR,CAT and PGE _(2) in the epidural anesthesia group were significantly lower than those in the general anesthesia group(all P<0.05).On the first day after operation,the levels of IL-6,IL-8 and PCT in the two groups were significantly higher than those before operation,and the levels of IL-6,IL-8 and PCT in the epidural anesthesia group were significantly lower than those in the general anesthesia group(all P<0.05).Conclusion:General anesthesia combined with epidural anesthesia can effectively reduce the dosage of muscle relaxant,improve hemodynamics,inhibit stress response and inflammatory factor release in patients with prostate cancer during operatio

关 键 词：全身麻醉 硬膜外麻醉 前列腺癌 肌松剂 应激反应 血流动力学 

分 类 号：R737.1[医药卫生—肿瘤]