腰-硬联合麻醉复合咪达唑仑在妇科腹腔镜手术的应用

The application of combined spinal - epidural anesthesia and combined Midazolam used for laparoscopic gynecology Operation

目的探讨腰-硬联合麻醉复合咪达唑仑应用于妇科腹腔镜手术的可行性和安全性。方法择期妇科腹腔镜手术的病人（ASAⅠ～Ⅱ级）500例，随机分成腰-硬联合麻醉复合咪达唑仑组（CSEA组）和气管内插管全身麻醉组（全麻组），各250例，记录HR、RR、MAP、SpO2以及清醒时间、术后24小时不良反应，并进行对比研究。结果两组HR、RR、MAP、SpO2麻醉前后变化比较差异无显著性（P〉0．05），而清醒时间、不良反应方面CSEA组均优于全麻组。结论腰-硬联合麻醉复合咪达唑仑应用于妇科腹腔镜手术的可行的和安全的，较全身麻醉简便、经济。

Objective To evaluate the safety and feasibility of combined spinal-epidm＇al anesthesia and combined Midazolam used for laparoscopic gynecology Operation.Methods 500 patients of ASA grade Ⅰ～Ⅱundezgoing laparoseopic gynecology surgery were randomly devided into combined spinalepidural anesthesia group （ group CSEA , n = 250 ） and general anesthesia group （ group GA, n = 250 ）,The variation of pert-anesthesia mean heart rate（ HR ）, respiration rate（ RR ）, arterial pressure（ MAP ）, pulse oxygen saturation （ SpO2 ） were tested and recorded. The wake time and the post-operative （ in 24hour ） complications were observed. Results Referring to all patients, there were not any significant differences in BP, HR, RR, SpO2 （ P〉 0.05 ）.The wake time was signifieantly shorter in Group CSEA than in Group GA （ P〈 0.0l ）, The incidence of postoperative complication （ nausea, vomiting, restlessness ） was significantly lower in Group CSEA than in Group GA （ P〈 0.05 ）.Conclusion The combined spinal-epidural anesthesia and combined Midazolam used for lapamscopic gynecology Operation is safe and feasible , and easier and more economical general anesthesia.