两种不同麻醉方式下后腹膜腔镜手术CO_2气腹对机体的影响

Epidural versus general anesthesia for effects of carbon dioxide on influence of organism undergoing retroperitoneoscopy

目的讨论后腹膜腔镜下手术CO气腹对血流动力学、气体交换及动脉血气的影响。方法20例2后腹膜腔镜下手术的择期病人,分为两组:硬膜外组和全麻插管组,于麻醉前、CO充气前、充气后5、10、30、60、2180和240min分别观测并记录血压(BP),心率(HR),血氧饱和度(SpO),呼吸末二氧化碳分压(PETCO)22等参数,并行动脉血气分析,观察其变化。结果麻醉后,全麻插管组比硬膜外组的BP、HR变化大,有统计学意义(P<0.05),充气后60min两组组内比较与充气前的PETCO、PaCO显著增高(P<0.05),pH显著下降22(P<0.05),但两组组间比较差异无显著性(P>0.05)。结论两组均于充气后60min机体内PETCO、PaCO22和pH的变化最大,60min后处于相对稳定,气腹前、后硬膜外麻醉组BP、HR变化较全麻插管组明显,但对血气以及气体交换的影响两种麻醉方式无明显差异。

Epidural versus general anesthesia for effects of carbon dioxide on the influence of organism undergoing retroperitoneoscopy. Were assessed in 20 retroperitoneoscopy patients undergoing elective operation. Patients were allocated randomly to different two groups, Epidural anesthesia groups and General anesthesia groups. Before anesthesia, before and after carbon dioxide was suffused, observe the change of BP, HR, SpO2, PETCO2 at 5, 10, 30, 60, 180 and 240 min, and analyse the blood gas at different time. After anesthesia, the changes of BP, HR in Epidural anesthesia groups were signifincantly than General anesthesia groups.(P<0.05), in same groups before charge and within 60 min charge the change of BP, HR, PETCO2, PaCO2 were increased signifincantly and pH is decreased signifincantly, between two groups the change were no difference (P>0.05). [Conclusions] Carbon dioxide affect signifincantly within 60 min charge and go to stabilize after 60 min, between before charge and after charge the changes of BP, HR in Epidural anesthesia groups are signifincantly than general anesthesia groups, but the changes of blood gas and gas exchange in Epidural anesthesia groups are no difference with General anesthesia groups.