不同麻醉方法在腹腔镜下行妇科不孕检查及治疗术中的临床比较

The Clinical Research on Effects of Different Anesthetic Techniques on the Examination and Treatment of Infertility in Patients during Laparoscopic

目的:比较不同麻醉方法在腹腔镜妇科不孕检查及治疗术中的效果和安全性。方法:选择不孕拟在腹腔镜下行检查及治疗术的患者60例,随机分为三组,每组20人,分别进行连续硬膜外麻醉(简称EA组);静吸复合全身麻醉(简称GA组);连续硬膜外麻醉加静吸复合全身麻醉(简称EGA组),观察比较三种麻醉方法对患者呼吸,循环及麻醉效果的影响。结果:三种麻醉方法均可保证手术完成,EA组术中管理较为麻烦,GA组循环波动大,EGA组麻醉效果更好,各种药物用量减少,患者血液动力学更稳定,恢复快,管理更轻松。结论:连续硬膜外麻醉加静吸复合全身麻醉(EGA)可避免其它两种麻醉方式不足,各取长处,更适用于腹腔镜妇科不孕检查及治疗术麻醉。

Objective： The study was undertaken to compare the efficacy and safety of different anesthetic techniques on the examination and treatment of infertility during Laparoscopic. Methods： Sixty ASA-1 patients were randomly assigned into epidural anesthesia group （group EA, n=20）, general anesthesia （group GA, n=20） or combined general anesthesia with epidural anesthesia （group EGA, n= 20）. The changes of heart rates and blood pressure （MAP） were recorded at baseline, after induction, tracheal intubation, 1 min, 3 min after intubation, and extubation. The other variables such as SPO2, predict body movement, awaken time and extuhation time were also recorded. Results： There was no obvious difference in each observed point in group EGA. The decreasing of blood pressure after anesthesia induction was similar in all three groups （P〉0.05）. In group GA, the changes of MAP, HR during intubation and extubation were higher significantly than the baseline （P〈0.05）, and significant higher than those of in group EGA （P〈0.01）. The incidence of predict body movement between group EA and group EGA was eight to nil （P〈0.01）. In group EGA, the recovery of respiratory time, awaken time and extubation time were significantly shorten compared with group GA. Conclusion： As compared with the general anesthesia and epidural anesthesia, EGA may attenuate the cardiovascular responses to stress more effectively and improve homodynamic; and has a reliable re- covery of anesthesia property with low side effects during laparoscopic.