腹腔镜下阑尾切除术中不同麻醉方法对应激反应的影响

Effect of different anaesthesia methods on stress reaction during laparoscopic appendectomy

目的观察在硬膜外麻醉和全身麻醉下腹腔镜阑尾切除术中血浆肾上腺素(E)、去甲肾上腺素(NE)的变化。方法将60例拟行腹腔镜阑尾切除术患者随机分为全身麻醉(GA)组和硬膜外(EA)组,每组30例,监测麻醉前、气腹前10 min、气腹后及放气后5 min各时点血浆NE、E浓度。结果 EA组术中各时点NE浓度无明显变化,气腹前、后E明显增高,术毕基本恢复;GA组气腹后NE和E明显增高。结论 2种麻醉方法术中均有应激反应,硬膜外麻醉下腹腔镜阑尾切除术中应激反应较全身麻醉轻。

Objective To investigate the change of plasma adrenaline（E） and norepinephrine（NE） during laparoscopic appendectomy under epidural and general anesthesia. Methods 60 patients undergoing laparoscopic appendectomy were ran domly divided into general anesthesia group （GA） and the epidural anesthesia group （EA） with 30 cases in each group. The con eentrations of plasma E and NE were measured before anaesthesia （T1）, before pneumoperitoneum （T2） and after pneumoperi- toneum（T3） ,and after operations（T4）. Results In the group EA,there was no obvious difference in the NE concentrations at T1, T2,T3 and T4, but the E concentrations were increased at T2 and T3 compared with those at T1 In the group GA, the concentrations of NE at T3 and E at T3 and 3？4 were higher than those at T1. Conclusion There is an obvious stress reaction in both EA and GA, but which of EA is milder than that of GA during laparoscopic appendectomy.