40例全麻结合连续硬膜外麻用于腹腔镜胆囊切除临床研究

Clinical investigation of general intravenous anesthesia combined continuous epidural anesthesia in laparoscopic cholecystectomy

目的:探讨气管插管全身麻醉、全身麻醉结合连续硬膜外麻醉等两种麻醉方法用于腹腔镜胆囊切除术的麻醉对循环、呼吸及围手术期清醒质量的影响。方法:将腹腔镜胆囊切除术80例分为两组:气管插管全身麻醉(A组),静脉全身麻醉结合连续硬膜外麻醉组(B组),于麻醉前、麻醉后、气腹后5min、术毕记录MAP、HR、PetCO2、SpO2,以及手术时间、拔管时间及两组异丙酚及异芬太尼的平均用量。结果:A和B两组麻醉各个时段HR、MAP、PetCO2及SpO2比较差异无显著性,且B组围手术期清醒质量较好。结论:在腹腔镜胆囊切除术麻醉中,全身麻醉复合硬膜外麻醉对循环和呼吸干扰小,清醒质量高且经济安全。

Objective：To investigate the clinical effects of general intravenous anesthesia combined continuous epidural anesthesia in laparoseopic cholecystectomy. Methods ：In this clinical investigation, 80 patients performed laparoscopic cholecystectomy were ran- domly divided into two groups：40 cases were under tracheal cannula general anesthesia （group A）,other 40 cases were under general intrsvenous anesthesia combined continuous epidural anesthesia.The effects of two types of anesthesia and the changes of hemodynamies （MAP, HR）, respiratory （PetCO2, SpCO2） and recovery time of orientation were observed.Results： MAP, HR, PetCO2, SpO2, of group B were more stable than those of group A. MAP was decreased significantly during CEA ,and SpO2 of CEA was decreased during CO2 insufflation. SEF of GMCEA group was higher than that of GA. The recovery quality of group B was better than that of group A. Conclusion：General intravenous anesthesia combined continuous epidural anesthesia is the safest technique and therefore recommended for laparoscopie cholecystectomy.It offers several advantages：quicker recovery, decreased PONV and fewer hemodynamic changes.