全麻复合腰硬联合麻醉在老年直肠癌根治术中的应用

Application of general anesthesia combined with spinal-epidural anesthesia in radical resection of older rectal cancer

目的:评价全麻复合腰硬联合麻醉在老年患者直肠癌根治术中的安全性。方法:40例ASAⅠ～Ⅱ级,年龄65～80岁择期直肠癌手术的患者,随机分为A组和B组,A级为全麻复合腰硬联合组,B组为单纯全麻组,分别观察两组患者手术期血流动力学变化,血气变化及全麻药用量。结果:两组患者手术期各时段HR、MAP变化A组均较B组轻且平稳,两组患者血气分析PaCO2、HCO3-均明显高于术前(P<0.01)。结论:全麻复合腰硬联合用于老年直肠癌根治术较单纯应用全身麻醉,全麻药用量明显减少,循环呼吸功能平稳且便于术后镇痛,是此类手术的最佳选择。

Objective： To evaluate the safety of general anesthesia combined with spinal-epidural anesthesia in elderly patients with rectal cancer. Methods： 40 patients with ASA I - II, age of 65-80, undergoing elective retal cancer surgery, were randomly divided into group A and group B, group A was given general anesthesia combined with spinal-epidural anesthesia, group B with merely general anesthesia group. Hemodynamic changes, blood gas changes and anesthetic dosage were observed respectively in the two groups during operation. Results： During operation, changes of HR and MAP were slighter and more stable in group A than group B. PaCO2 and HCO3^- in both groups were significantly higher than those before operation （P〈0.01）. Conclusion： General anesthesia combined with spinal-epidural anesthesia in radical resection of older rectal cancer compared with merely general anesthesia, whole anesthetic dosage significantly reduced, circulation and respiration function are more smooth and facilitate for postoperative analgesia. This kind of anesthesia is the best choice for this kind of surgery.