全身麻醉与硬膜外复合全身麻醉对老年腹腔镜胆囊切除术患者麻醉效果及应激反应的影响分析  

Analysis of the Effects of General Anesthesia and Epidural Combined General Anesthesia on Anesthesia Effect and Stress Response in Elderly Patients Undergoing Laparoscopic Cholecystectomy

作　　者：邱成毅 QIU Chengyi(Department of Anesthesiology,Liangshan County People's Hospital,Jining,Shandong Province,272600 China)

机构地区：[1]山东省梁山县人民医院麻醉科,山东济宁272600

出　　处：《系统医学》2024年第4期27-30,共4页Systems Medicine

摘　　要：目的 探讨老年腹腔镜胆囊切除术患者行全身麻醉、硬膜外复合全身麻醉的效果。方法 选取2021年6月—2023年7月于山东省梁山县人民医院接受腹腔镜胆囊切除术的80例老年患者为研究对象。基于麻醉方案的不同分为两组,各40例。对照组行全身麻醉,研究组行硬膜外复合全身麻醉,于手术结束后评定相关指标的变化。结果 研究组睁眼时间(12.84±2.74)min、清醒时间(16.83±2.36)min、定向力恢复时间(17.25±1.51)min优于对照组,差异有统计学意义(t=15.751、22.906、19.540,P均<0.05);研究组完成手术前5 min的皮质醇、去甲肾上腺素水平及术后2、24 h疼痛评分低于对照组,差异有统计学意义(P均<0.05)。结论 在老年腹腔镜胆囊切除术中行硬膜外复合全身麻醉,可稳定术中血流动力学指标,降低术中应激水平、术后疼痛程度。Objective To investigate the effects of general anesthesia and epidural combined general anesthesia in elderly laparoscopic cholecystectomy patients.Methods 80 patients from June 2021 to July 2023 who underwent geriatric laparoscopic cholecystectomy in the Liangshan County People's Hospital were selected as the study objects.They were divided into 2 groups with 40 cases in each group according to the different anesthesia plan.The control group uesd general anesthesia,the study group used epidural combined general anesthesia.The changes of related indexes were evaluated at the end of the operation.Results The study group's eye opening time(12.84±2.74) min,awake time(16.83±2.36) min,and orientation recovery time(17.25±1.51) min were better than those of the control group,and the differences were statistically significant(t=15.751,22.906,19.540,all P<0.05).Cortisol and norepinephrine levels 5min before completion of surgery and postoperative 2,24 h pain scores were lower in the study group than in the control group,the differences were statistically significant(all P<0.05).Conclusion Epidural combined general anesthesia in laparoscopic cholecystectomy in the elderly can stabilize intraoperative hemodynamic indexes,reduce the level of intraoperative stress and the degree of postoperative pain.

关 键 词：腹腔镜胆囊切除术 全身麻醉 硬膜外麻醉 麻醉效果 

分 类 号：R614.2[医药卫生—麻醉学]