全麻联合硬膜外麻醉在高血压患者腹腔镜胆囊切除术中的应用分析

Application analysis of general anesthesia combined epidural anesthesia in laparoscopic cholecystectomy for patients with hypertension

目的探讨全麻联合硬膜外麻醉在高血压患者腹腔镜胆囊切除术中的价值。方法将内江市第二人民医院行腹腔镜胆囊切除术的45例高血压患者,随机分成实验组25例和对照组20例,实验组给予全麻联合硬膜外麻醉麻醉,对照组给予单纯全麻,比较两组全麻前、气管插管后、气腹建立后及苏醒拔管后血流动力学指标收缩压(SBP)、舒张压(DBP)及心率(HR);比较两组全麻药物用量及麻醉恢复时间。结果实验组气管插管后、气腹建立后及苏醒拔管后血流动力学指标SBP、DBP及HR明显低于对照组,差异具有统计学意义(P<0.05);实验组全麻药物用量明显较对照组少,实验组麻醉自主呼吸恢复时间较对照组提前,差异均具有统计学意义(P<0.05)。结论全麻复合硬膜外麻醉用于高血压患者施行腹腔镜胆囊切除术,能明显减轻应激反应,维持血流动力学的稳定,减少全麻用药量,麻醉后苏醒快。

Objective To investigate the value of general anesthesia combining with epidural anesthesia on laparoscopic cholecystectomy for the patients with hypertension.Methods 45 patients with hypertension in our hospital were given laparoscopic cholecystectomy.All cases were randomly divided into the experimental group（25 cases） and the control group（20 cases）.The experimental group was given general anesthesia combining with epidural anesthesia and the control group was given general anesthesia.To compare the hemodynamic parameters including SBP,DBP and HR,before anesthesia,after tracheal intubation,after pneumoperitoneum establishment and after tracheal extubation in 2 groups.To compare the drug dosage of anesthesia and recovery time after anesthesia in 2 groups.Results SBP,DBP and HR after tracheal intubation,after pneumoperitoneum establishment and tracheal extubation in the experimental group were lower than those in the control group.The difference was statistically significant（P0.05）.The drug dosage for anesthesia in the experimental group was less than that in the control group.The recovery time of spontaneous breathing after anesthesia in the experimental group was shorter than that of the control group with statistical difference（P0.05）.Conclusion General anesthesia combining with epidural anesthesia in laparoscopic cholecystectomy for hypertensive patients can significantly reduce the stress response,maintain hemodynamic stability,reduce the dosage of anesthesia and rapidly recover after anesthesia.