单纯全麻与全麻复合硬膜外麻醉在妇科腹腔镜手术中的麻醉效果的比较

目的比较单纯全麻与全麻复合硬膜外麻醉的在妇科腹腔镜手术中麻醉的效果。方法选择期妇科腹腔镜手术40例,ASAⅠ～Ⅱ级,随机分外全麻组(G组)和全麻复合硬膜外麻醉组(EG组)各20例。G组麻醉维持采用丙泊酚,顺苯磺酸阿曲库铵,瑞芬太尼;EG组采用丙泊酚,顺苯磺酸阿曲库铵复合硬膜外麻醉维持。记录2组全麻用药量,术中血流动力学变化,术毕苏醒时间。术中由不知情的手术医师对子宫松弛度进行评级,分为优、良、差3组。结果 G组丙泊酚、顺苯磺酸阿曲库铵的用药量明显多于EG组(P<0.01),并且G组的苏醒时间明显长于EG组(P<0.01)。EG组的子宫松弛度明显优于G组(P<0.01)。G组的MAP高于、HR快于EG组(P<0.05)。结论全麻复合硬膜外麻醉,能有效阻滞子宫及其固定组织的神经支配,从而达到子宫松弛的目的,有利于手术操作,且能减少全麻用药量,血流动力学平稳,易于苏醒,是一种较好的麻醉方法。

Objective To compare the anesthesia and anesthesia combined with epidural anesthesia in gynecologic laparoscopic surgery anesthetic effect.Methods Forty ASA Ⅰ～Ⅱ patients of gynecological laparoscopic surgery,were randomly exceptionally anesthesia group （G group） and anesthesia combined with epidural anesthesia group （EG group）.The anesthesia of group G was maintained with propofol,atracurium besylate,hydrochloride;EG group was maintained with propofol,atracurium besylate and epidural anesthesia.Record the dosage,hemodynamic changes,surgery recovery time.The degree of relaxation of the uterus rating,is divided into excellent,good, bad three groups by surgeon.Results The dosage of the propofol and atracurium besylate medication in G group was significantly more than the EG group（P0.01）.The recovery time of the group G was significantly longer than the EG group（P0.01）.The laxity of the uterus in EG group was significantly better than G group （P0.01）.The MAP of the G group was higher than the EG group, and the HR of the G group was faster than the EG group （P0.05）.Conclusion Anesthesia combined with epidural anesthesia,can effectively block the uterus and fixed nerve tissue,so as to achieve the purpose of uterine relaxation,conducive to surgical operation, can reduce the dosage of anesthesia,hemodynamic stability,easy to wake up,is a better method of anesthesia.