腹腔镜手术硬膜外阻滞及辅助药对SpO_2影响的比较

Effect of epidural-supportive anesthesia in abdominal scope surgery on SpO_2

目的观察腹腔镜手术硬膜外阻滞及辅助药对SpO2 的影响 ,以期正确地估价对呼吸功能的影响程度 ,分析其原因并探讨预防措施。方法选择无呼吸、循环功能异常的腹腔镜手术病人6 0例 ,分为腹腔镜胆囊手术组 (简称胆囊组 )和腹腔镜妇科手术组 (简称妇科组 ) ,每组各 30例 ,各组均持续监测病人SpO2 ,记录硬膜外阻滞前、硬膜外阻滞平面固定后、气腹压力稳定后及应用辅助药物后SpO2 的最低值和持续时间。测定时排除循环不良对SpO2 的干扰。结果硬膜外阻滞平面固定后 ,胆囊组病人SpO2 有轻微下降 ,妇科组病人SpO2 基本无变化 ;气腹压力稳定后 ,两组病人SpO2 均有轻度下降 ;应用辅助药物后 ,两组病人SpO2 均有显著下降 ,其中胆囊组SpO2 ≤ 94 % (88%～ 94 % )者有 15例(占 5 0 % ) ,妇科组SpO2 ≤ 94 % (90 %～ 94 % )者有 8例 (约占 36 % )。结论腹腔镜手术硬膜外阻滞及辅助药物对呼吸功能影响较大 ,手术全程宜常规吸氧或辅助呼吸 ,合理应用辅助药、加强术中呼吸管理和严密监测至关重要。

Objective To study the effect of epidural supportive anesthesia in abdominal scope surgery on SpO 2. Methods 60 patients were divided into 2 groups randomly. SpO 2 were monitored continuously. The lowest value of SpO 2 and the duration were recorded before epidural supportive anesthesia, in the quiescency of epidural block and CO 2 pneumoperitionium, and after supportive anesthesia. Results SpO 2 were significantly decreased after supportive anesthesia. Conclusion Respiratory function can be effected by epidural supportive anesthesia in abdominal scope surgery. Oxygen and assistant ventilation were necessary. It is important to use the assistant medicine properly.