全身麻醉与硬膜外麻醉在妇科腹腔镜手术中对呼吸、循环的影响

Effects of peridural and general anesthesia on respiration and circulation in gynecological laparoscopic operation

目的比较不同麻醉方式在妇科腹腔镜手术中对呼吸、循环的影响。方法56例妇科腹腔镜手术,分为全身麻醉与硬膜外麻醉2组,每组28例,分别于气腹前及气腹后10、20、30、40min、放气腹后5min,记录血压、心率、脉搏氧饱和度、呼气末二氧化碳、潮气量、呼吸频率、每分通气量及气道压。结果术毕清醒时间硬膜外组明显短于全麻组(P<0·05),气腹后20min、30min潮气量硬膜外组明显小于全麻组(P<0·05),各时点呼吸频率、分钟通气量、气道压硬膜外组分别明显快于、大于、低于全麻组(P<0·05),其余各项指标两组无显著差异。结论在妇科腹腔镜手术中,两种麻醉方式对呼吸、循环的影响无显著差异。

Objective To compare the influences of peridural and general anesthesia on respiration and circulation in gynecological laparoscopic operation. Methods Fifty-six patients, underwent gynecological laparoscopic operation during June to October, 2003, are divided into two groups. The items of respiration and circulation recorded before and 10, 20, 30, 40rain after pneumoperitoneum as well as 5 rnin after deflation abdomen were as follows： blood pressure （BP）, heart rate （HR）, sphygrnus oxygen saturation （SpO2）, end-expiratory pressure of CO2 （PETCO2）, tidal volume, frequency of respiration, minute ventilation volume and airway pressure. Results The re-consciousness time after the operation in the periduml anesthesia group is significantly less than that in the general anesthesia group （P〈0. 05）. At 20 and 30 rain after pneumoperitoneum the tidal volume in the former is less than that in the latter （P〈0. 05）. The respiration frequency is quicker, minute ventilation volume is greater and the airway pressure is lower respectively in the former than that in the latter （P〈0. 05）. No significant difference was found on the other items between the two groups （P〈0. 05）. Conelusion In gynecological laparoscopic operation, no significant difference was found concerning the influence of the two anesthesia manners on respiration and circulation.