小剂量轻比重罗哌卡因腰-硬联合麻醉在妇产科腹腔镜手术中应用对患者应激反应的影响

Effect of low dose of hypobaric ropivacaine for combined spinal epidural anesthesia on stress reaction in the Department of Obstetrics and gynecology in laparoscopic surgery

目的观察小剂量轻比重罗哌卡因腰-硬联合麻醉在妇产科腹腔镜手术中应用对患者应激反应的影响。方法选择行腹腔镜妇产科患者160例,随机分为2组:小剂量轻比重罗哌卡因腰-硬联合麻醉组(A组)、全麻组(B组)各80例,于术前,切皮,气腹20分钟和术毕10分钟四个时间点,采集静脉血测定肾上腺素(E)、去甲肾上腺素(NE)、血糖、皮质醇,并观察血流动力学变化。结果经过观察发现两组MAP和HR在手术前均无明显的统计学差异(P>0.05),而在切皮气腹20分钟、术毕10分钟各时间点A组明显低于B组,差异均有明显统计学意义(P<0.05);E和NE在手术前均无明显的统计学差异(P>0.05),而在切皮和气腹20分钟时间点A组明显低于B组,差异均有统计学意义(P<0.05);组血糖及皮质醇在手术前均无明显的统计学差异(P>0.05),而在切皮和气腹20分钟时间点A组明显低于B组,差异均有统计学意义(P<0.05)。结论小剂量轻比重罗哌卡目腰-硬联合麻醉降低气腹对腹腔镜手术患者的应激反应,保持循环系统稳定。

Objective To observe the Stress effects of Small-dose Low-concentration and Hypobaric Ropivacaine for combined spinal-epidural anesthesia on gynecological laparoscopic.Methods 160 patients with laparoscopic hysterectomy patients were randomly divided into two groups.80 patients by Small-dose Low-concentration and Hypobaric Ropivacaine for combined spinal-epidural anesthesia(A Group) and another 60 patients by gGeneral Anesthesia(B group).Prior to surgery,incision,pneumoperitoneum 20 minutes and 10 minutes of surgery four time * points,collected blood was measured epinephrine(E),norepinephrine(NE),hemodynamic changes were observed.Results after MAP and HR observed in both groups before surgery had no statistically significant difference(p> 0.05),while in the incision pneumoperitoneum 20 minutes of surgery 10 minutes each time point in group A was significantly lower than group B,the differences were there are statistically significant(P <0.05);E and NE before surgery had no statistically significant difference(p> 0.05),and in 20 minutes of abdominal incision point in time and gas group A was significantly lower than group B,the differences were there was statistically significant(P <0.05);blood glucose and Cortisol before surgery had no statistically significant difference(p> 0.05),and in 20 minutes of abdominal incision point in time and gas group A was significantly lower than group B,the difference were statistically significant(P <0.05)..Conclusions Stress effects of Smalldose Low-concentration and Hypobaric Ropivacaine to reduce stress on the pneumoperitoneum laparoscopic surgery patients remain stable circulation.