全身麻醉联合硬膜外麻醉在腹腔镜下直肠癌根治术中的应用价值分析

Application value of general anesthesia and epidural anesthesia in laparoscopic radical resection of rectal cancer

目的 探讨腹腔镜下直肠癌根治术中全身麻醉联合硬膜外麻醉的应用价值。方法 选择2017年6月至2019年1月期间在本院行腹腔镜下直肠癌根治术的160例患者为研究对象,随机将其分为观察组与对照组,每组80例,其中观察组采取全身麻醉联合硬膜外麻醉,对照组采取全身麻醉;比较两组患者的麻醉效果、心率与平均动脉压、苏醒质量以及并发症发生情况。结果 观察组的优良率明显高于对照组(97.50%比81.25%),两组比较差异有统计学意义(P<0.05);观察组气腹前10min、气腹后10min的心率及平均动脉压均明显小于对照组(P<0.05),而麻醉前、放气后5min的心率及平均动脉压比较差异无统计学意义(P>0.05);观察组的拔管时间、睁眼时间均明显短于对照组(P<0.05);观察组无苏醒期躁动患者,而对照组有5例(6.25%)苏醒期躁动患者,对照组苏醒期躁动发生率明显高于观察组(P<0.05);观察组并发症发生率明显低于对照组(5.00%比18.75%),两组比较差异有统计学意义(P<0.05)。结论 全身麻醉联合硬膜外麻醉可增强麻醉效果,且围术期心率、血压更为稳定,苏醒期质量更好,并发症发生率更低,值得在临床上推广应用。

Objective To investigate the value of general anesthesia combined with epidural anesthesia in laparoscopic radical resection of rectal cancer. Methods A total of 160 patients who underwent radical laparoscopic rectal cancer in our hospital from June, 2017 to January, 2019 were enrolled in the study, were randomly divided into an observation group and a control group, with 80 cases in each group. The observation group underwent general anesthesia and epidural anesthesia, and the control group general anesthesia. The anesthesia effect, heart rate, mean arterial pressure, quality of recovery, and complications were compared between the two groups. Results The excellent and good rate in the observation group was 97.50%, significantly higher than that in the control group (81.25%)(P < 0.05). The heart rate and average arterial pressure of the observation group were significantly lower than those of the control group 10 min before and 10 min after pneumoperitoneum (all P < 0.05);while there were no statistical differences in heart rate and average arterial pressure before anesthesia and 5 min after ventilation between the two groups (all P > 0.05). The extubation time and eye opening time in the observation group were significantly shorter than those in the control group (P < 0.05). No patient had awakening agitation in the observation group, and 5 (6.25%) in the control group;the incidence of awakening agitation in the control group was significantly higher than that in the observation group (P < 0.05). The incidence of complications was significantly lower in the observation group than in the control group (5.00% vs. 18.75%, P < 0.05). Conclusion General anesthesia combined with epidural anesthesia can enhance the anesthetic effect, make the perioperative heart rate and blood pressure stable, and decrease the incidence of complications, and has quality of recovery, so it is worth for clinical application.