硬膜外阻滞复合全麻对宫颈癌根治术中安全性及术后苏醒质量、术后疼痛的影响  

Epidural Block Combined with General Anaesthesia on Safety During Radical Cervical Cancer Surgery and Postoperative Quality of Recovery,Postoperative Pain

作　　者：许云平 崔淑萍 XU Yunping;CUI Shuping(Department of Gynecology,Xingyang Maternal and Children Health Hospital,Zhengzhou Henan 450100,China)

机构地区：[1]荥阳市妇幼保健院妇科,河南郑州450100

出　　处：《临床研究》2023年第6期56-59,共4页Clinical Research

摘　　要：目的 探讨硬膜外阻滞复合全麻对宫颈癌根治术中安全性及术后苏醒质量、术后疼痛的影响。方法 选取2019年5月至2021年4月在荥阳市妇幼保健院接受宫颈癌根治术的96例患者,采用随机数字表法分为对照组和研究组,每组各48例。研究组术中采用硬膜外阻滞复合全麻麻醉,对照组采用全身麻醉,观察患者术中应激反应相关指标,并对患者术后术后感染率、拔管时间、苏醒时间、疼痛进行评价。结果 麻醉前30 min(T_(0)),两组患者平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2) )、血管紧张素Ⅱ(AngⅡ)及皮质醇(Cor)水平比较,差异无统计学意义(P>0.05);切皮时(T_(1))、术后10 min(T_(2))及手术结束时(T_(3)),两组患者MAP、HR、AngⅡ及Cor水平均有所升高,SpO_(2) 水平有所下降,研究组改变幅度明显小于对照组,差异有统计学意义(P<0.05);研究组术后的Steward评分明显高于对照组,术后24 h视觉模拟评分(VAS)明显低于对照组,差异有统计学意义(P<0.05);研究组麻醉苏醒期不良反应发生率显著低于对照组,差异有统计学意义(P<0.05);两组患者术后感染率、拔管时间、苏醒时间比较,观察组术后感染率为2.08%,明显低于对照组,观察组拔管时间及苏醒时间分别为(18.63±2.11)min、(14.58±1.30)min,均短于对照组,差异有统计学意义(P<0.05)。结论 宫颈癌根治术采用硬膜外阻滞复合全麻手术方式可有效减轻宫颈癌根治术术中患者的应激反应,术后苏醒迅速、镇痛充分,可作为安全有效的麻醉方式应用。Objective To investigate the effects of epidural block compounded with general anesthesia on the safety during radical cervical cancer surgery and the quality of postoperative awakening and postoperative pain.Methods A total of 96 patients who underwent radical cervical cancer surgery at Xingyang Maternal and Children Health Hospital from May 2019 to April 2021 were selected,and the patients were divided into a study group and a control group using the random number expression,with 48 cases in each group.In the study group,general anesthesia with epidural block was used,and in control group,the general anesthesia was used.The intraoperative stress responses were observed,and the postoperative infection rate,extubation time,awakening time,and pain were evaluated.Results There was no difference in the levels of mean arterial blood pressure(MAP),heart rate(HR),oxyhemoglobin saturation(SpO_(2) ),angiotensinⅡ(AngⅡ)and cortisol(Cor)between the two groups 30 min before anesthesia(T_(0));At the time of incision(T_(1)),10 min after surgery(T_(2))and at the end of surgery(T3),the levels of MAP,HR,Ang II and Cor in the two groups were increased,and SpO_(2) levels decreased,but the magnitude of change in the study group was significantly less than in the control group,with significant differences(P<0.05);The postoperative Steward awakening score in the study group was higher than control group,the 24 h postoperative Visual Analogue Score(VAS)was lower than control group,with significant differences(P<0.05);The incidence of adverse reactions during anesthesia recovery in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05);The infection rate of the observation group was 2.08%,which was significantly lower than that of the control group.The extubation time and recovery time of the observation group were(18.63±2.11)min and(14.58±1.30)min,which were shorter than those of the control group,and the differences were statistically significant(P<0.05).Co

关 键 词：硬膜外阻滞 全麻 宫颈癌根治术 苏醒质量 术后疼痛 

分 类 号：R737.33[医药卫生—肿瘤]