全麻复合硬膜外阻滞麻醉对胆囊息肉患者腹腔镜手术应激反应及拔管时间的影响

Effect of general anesthesia combined with epidural block anesthesia on stress response and extubation time in patients with gallbladder polyps undergoing laparoscopic surgery

目的研究全麻复合硬膜外阻滞麻醉对胆囊息肉患者腹腔镜手术应激反应及拔管时间的影响。方法将我院行腹腔镜胆囊切除术(LC)治疗的100例胆囊息肉患者按照随机数字表法分为观察组(全麻复合硬膜外阻滞麻醉)和对照组(全麻),各50例。比较两组的麻醉药物用量、术后麻醉恢复情况及相关应激反应指标水平。结果观察组异丙酚、瑞芬太尼、阿曲库铵的用量及拔管时间、睁眼时间、清醒时间均优于对照组(P<0.05)。气腹后20 min、术毕放气后10 min,观察组的E、NE、COS水平波动均小于对照组(P<0.05)。结论全麻复合硬膜外阻滞麻醉可减轻行LC治疗的胆囊息肉患者应激反应,并减少麻醉药物用量,缩短术后恢复时间,值得临床推广。

Objective To study the effects of general anesthesia combined with epidural block anesthesia on stress response and extubation time in patients with gallbladder polyps undergoing laparoscopic surgery. Methods A total of 100 patients with gallbladder polyps treated with laparoscopic cholecystectomy(LC) in our hospital were divided into observation group(general anesthesia combined with epidural block anesthesia) and control group(general anesthesia) by random number table method, with 50 cases in each group. The dosage of anesthetics, postoperative anesthesia recovery and levels of related stress response indexes were compared between the two groups. Results The dosage of propofol, remifentanil and atracurium,extubation time, eye opening time and waking time in the observation group were better than those in the control group(P<0.05). At 20 minutes after pneumoperitoneum and 10 minutes after postoperative deflation, the fluctuations of E, NE and COS levels in the observation group were less than those in the control group(P<0.05). Conclusion General anesthesia combined with epidural block anesthesia can alleviate the stress reaction of patients with gallbladder polyps treated with LC, reduce the dosage of anesthetics and shorten the recovery time after operation, which is worthy of clinical promotion.