妇科腔镜手术中连续硬膜外麻醉与全身麻醉应用比较

Comparison of Continuous Epidural Anesthesia and General Anesthesia for Gynecology Laparoscope Operation

目的：比较连续硬膜外麻醉与全身麻醉用于妇科腔镜手术的麻醉效果与安全性.方法：选择50例ASAⅠ～Ⅱ级择期行妇科腔镜手术的患者,随机分为全麻组（G组）和连续硬膜外麻醉组（C组）,每组25例.G组行常规气管插管全麻,C组选L2～3间隙穿刺行硬膜外麻醉.记录并比较两组患者麻醉前、气腹前10 min、气腹后10 min、术后10 min的血压、心率、脉搏、氧分压、二氧化碳分压、pH值等.结果：C组患者气腹后血压、心率及呼气末二氧化碳分压较麻醉前升高（P＜0.05）,且比G组同一时间点的相应数值高（P＜0.05）.结论：在妇科腔镜手术中,气管插管全麻较连续硬膜外麻醉更为安全可行.

Objective：To compare the effect and safety of continuous epidural anesthesia and general anesthesia for gynecology laparoscope operation. Methods：Fifty cases with ASA Ⅰ-Ⅱ underwent gynaecologi- ca1 laparoscope were randomly divided into general anesthesia group （G） and continuous epidural anesthesia group （C） （ n = 25 ）. Group G was regularly given general anesthesia with tracheal intubation, and group C was given continuous epidural anesthesia by puncturing on L2 -3 vertebra interval. Blood pressure, heart rate, pulse, partial pressure of oxygen, partial pressure of carbon dioxide and pH value were recorded before anesthesia, lOmin before and after pneumoperitoneum and 10min after operation. Results： Blood pressure, heart rate and partial pressure of carbon dioxide in endexpiratory gas of group C were higher than pre -anesthesia（ P 〈 0. 05 ） and group G at the same point. Conclusions：The general anesthesia with tracheal intubation is safer and more feasible than continuous epidural anesthesia for gynecology laparoscope operation.