不同复合麻醉方式在腹股沟疝腹腔镜修补术中的影响

Effects of different combined anesthesia to laparoscopic inguinal hernia repair

目的比较不同复合麻醉方式对腹腔镜手术效果的影响。方法回顾性分析2010年5月至2013年12月,唐山市玉田县计生中心医院收治的腹股沟疝患者112例,随机分为二组,每组各56例,A组采用静吸复合全身麻醉,B组采用腰硬联合麻醉,比较二组患者的麻醉效果、麻醉起效时间、麻醉持续时间、术毕持续时间、并发症发生情况。结果 A组的麻醉优良率为94.6%,B组为96.4%,二组之间比较差异有统计学意义(χ2=19.13,P=0.02)。A组麻醉起效时间(9.0±1.2)min,B组麻醉起效时间(6.3±1.6)min,二组比较差异有统计学意义(t=15.01,P=0.001)。A组的麻醉不良反应发生率为10.7%,B组为8.9%,差异有统计学意义(χ2=0.32,P=0.002)。结论静吸复合全身麻醉与腰硬联合麻醉应用于腹股沟疝腹腔镜手术中均能起到良好的麻醉效果,腰硬联合麻醉缩短了麻醉起效时间,并发症发生率低,值得临床推广应用。

Objective To compare the effects of different combined anesthesia to laparoscopic inguinal hernia repair. Methods Between May 2010 and December 2013, a retrospective analysis was performed in 112 cases of inguinal hernia who were admitted to Yutian Family Planning Center Hospital. All patients were divided into two groups with equal amount （56 cases in each group） based on different anesthetic methods： intravenous-inhalation combined anesthesia in Group A and combined spinal-epidural anesthesia in Group B. The anesthesia effect, onset time, duration, postoperative duration, and complications were compared between two groups. Results Good anesthesia rate was 94.6% in Group A, and 96.4% in Group B, this difference was statistically significant （X^2 = 19. 13, P =0. 02）. There was significant difference in anesthesia onset time between Group A and Group B （9.0 -＋ 1.2 minutes vs. 6.3 ~ 1.6 minutes, t = 15.01, P = 0.001 ）. The adverse effects of anesthesia occurred more frequently in Group A than Group B （ 10.7% vs. 8.9%, X^2 = 0. 32, P = 0. 002）. Conclusion Both intravenous-inhalation combined anesthesia and combined spinal-epidural anesthesiacan play a good effect in laparoscopic inguinal hernia repair. We promote the use of combined spinal-epidural anesthesia popularized, as it shows a shorter onset time of anesthesia and less complications.