妇科腹腔镜手术气腹对患者腰部硬膜外腔压力的影响

Influence of pneumoperitoneum on lumbar epidural space pressure during laparoscopic gynecological operation

目的 了解CO2气腹对腰部硬膜外腔压力的影响。方法 选择ASAⅠ～Ⅱ级的择期妇科腹腔镜手术患者30例，所有患者均在硬膜外麻醉复合静脉全麻下进行腹腔镜手术，测定患者术前和术中腰部硬膜外腔压力的变化以及SBP、DBP、HR、PETCO2、SpO2等指标的变化。结果 术中患者腰部硬膜外腔压力均显著升高，CO2气腹时SBP、DBP、HR无明显变化，PetCO2在气腹的建立和维持中逐步升高，但在手术结束气腹消除后逐步恢复至正常水平。结论 CO2气腹可显著提高患者腰部硬膜外腔压力。

Objective To investigate the influence of carbon dioxide pneumoperitoneum on lumbar epidural spae pressure. Methods Thirty patients,ASA Ⅰ - Ⅱ ,undergoing laparoscopic gynecological operation by combined epidural and general anesthesia were included in this study. The lumbar epidural space pressure was measured before and during operation. Meanwhile,blood pressure, heart rate,PET CO2 and SpO2 were monitored and recorded continuously. Results The lumbar epidural space pressure increased significantly during pneumoperitoneum. The heart rate and blood pressure were stable,while PETCO2 increased significantly during pneumoperitoneum,and then decreased gradually to the pre- pneumoperitoneum level after peritoneal deflation. Conclusion Carbon dioxide pneumoperitoneum for laparoscopy can significantly increase the lumbar epidural space pressure.