全麻与腰硬联合麻醉应用于腹腔镜阑尾切除术的可行性研究

GENERAL VS COMBINED SPINAL EPIDURAL ANESTHESIA FOR LAPAROSCOPIC APPENDECTOMY:A FEASIBILITY STUDY

目的研究全麻与腰硬联合麻醉应用于腹腔镜阑尾切除术中的可行性。方法对比研究腹腔镜阑尾切除术采用全身麻醉和腰硬联合麻醉的优缺点,50例接受腹腔镜阑尾切除术的患者随机分为二组,全身麻醉组,腰硬联合麻醉组,每组25例。术中监测各项指标,术后疼痛、并发症、恢复时间和患者满意度,以及医疗成本都进行比较。结果所有手术均按选择麻醉方式完成。腰硬联合麻醉组术后4,8,12h疼痛评分显著低于全麻组,并且住院总费用较全麻组显著降低。术后评估发现所有患者对腰硬联合麻醉满意。结论腰硬联合麻醉配合CO2低压气腹应用于腹腔镜阑尾切除术具有良好的安全性和可行性。腰硬联合麻醉具有术后疼痛轻,恢复快,并且住院总费用比全身麻醉明显降低。

Objective To compare the possibility of performing laparoscopic appendectomy under combined spinal epidural anesthesia versus general anesthesia .Methods A comparative study between two groups of patients submitted to laparoscopic appendectomy using either general anesthesia or combined spinal epidural anesthesia .Fifty patients undergoing laparoscopic appendectomy divided into two groups ,25 patients in each group .Group Ⅰ received general anesthesia ,and group Ⅱ received a combined spinal epidural anes-thesia .Intraoperative monitoring ,postoperative pain ,complications ,recovery time ,patient satisfaction , and cost were compared between both groups .Results All surgical procedures were completed with the chosen method .Pain was significantly lower at 4 ,8 ,and 12 hours after the procedure under spinal anes-thesia .The cost of the combined spinal epidural anesthesia was significantly lower than that of the general anesthesia .In the postoperative evaluation ,all patients were satisfied with the combined spinal epidural an-esthesia .Conclusions Laparoscopic appendectomy with low -pressure pneumoperitoneum with CO2 can be safely performed under combined spinal epidural anesthesia .Combined spinal epidural anesthesia with an extremely low level of postoperative pain ,better recovery ,and lower cost than general anesthesia .