不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者的影响

Effects of different analgesic methods on patients with laparoscopic resection of colorectal cancer

目的:比较全身麻醉联合硬膜外镇痛和全身麻醉复合静脉镇痛两种麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后恢复的影响。方法:选择行腹腔镜结直肠癌根治术患者61例,根据其麻醉镇痛方法分为A组(全身麻醉联合硬膜外镇痛组,n=30)和B组(全身麻醉复合静脉镇痛组,n=31)。比较两组患者术中七氟醚、舒芬太尼和麻黄碱的用量,术毕自主呼吸恢复、苏醒、及拔除气管导管所需时间,术后1、6、12、24、48 h的VAS评分,术后肛门排气、进食、下床活动和不良反应发生情况等。结果:A组患者术中七氟醚和舒芬太尼用量显著低于B组,麻黄碱用量显著高于B组;术毕自主呼吸恢复、苏醒、拔除气管导管时间及术后肛门排气、进食、下床活动时间均短于B组;术后1、6、12、24、48 h的VAS评分低于B组;差异均有统计学意义(P<0.05);不良反应发生情况无显著差异。结论:与全身麻醉复合静脉镇痛相比,全身麻醉联合硬膜外镇痛更有利于腹腔镜结直肠癌根治术患者的术后恢复。

Objective:To compare the effects of general anesthesia combined with epidural analgesia or intravenous analgesia on patients with laparoscopic resection of colorectal cancer.Methods:Sixty-one patients with laparoscopic resection of colorectal cancer were selected and divided into group A(general anesthesia combined with epidural analgesia group,n=30)and group B(general anesthesia combined with intravenous analgesia group,n=31)based on their analgesic methods.The dosage of sevoflurane,sufentanil and ephedrine during operation,the time needed for spontaneous breathing recovery,awakening and tracheal tube removal after operation,VAS score at postoperative 1,6,12,24 and 48 hours,anal exhaust,feeding,out-of-bed activities and adverse reactions were compared between the two groups.Results:The dosage of sevoflurane and sufentanil was significantly lower and the dosage of ephedrine was significantly higher in group A than group B.The time for spontaneous breathing recovery,awakening,extubation of tracheal tube and anal exhaust,eating and getting out of bed after operation were shorter and VAS scores at postoperative 1,6,12,24 and 48 hours were lower in group A than B(P<0.05).There were no significant differences in the occurrence of adverse reactions.Conclusion:Compared with general anesthesia combined with intravenous analgesia,general anesthesia combined with epidural analgesia is better for postoperative recovery of patients with laparoscopic resection of colorectal cancer.