全麻联合硬膜外阻滞麻醉对胆囊息肉腹腔镜手术患者应激反应、麻醉恢复及术后认知功能的影响

Effects of general anesthesia combined with epidural block anesthesia on stress response,anesthesia recovery and postoperative cognitive function in patients undergoing laparoscopic surgery for gallbladder polyps

目的探讨胆囊息肉腹腔镜手术中应用全麻联合硬膜外阻滞麻醉对应激反应、麻醉恢复及术后认知功能的影响。方法按照随机抽样法选取于我院行胆囊息肉腹腔镜手术的200例患者作为研究对象,采用随机数字表法将其分为对照组(100例,全麻)和研究组(100例,全麻+硬膜外阻滞麻醉)。比较两组的麻醉效果。结果气管插管后5 min(T1)、切皮后5 min(T2)、手术30 min(T3)、术毕拔管后5 min(T4)时,两组的AgⅡ、NE、IL-10水平均较麻醉前(T0)有所升高,但研究组明显低于对照组(P<0.05)。研究组拔管、睁眼、清醒时间均显著短于对照组(P<0.05)。术后1、3 d,两组的MMSE评分均低于术前,但研究组明显高于对照组(P<0.05)。结论全麻联合硬膜外阻滞麻醉可减轻胆囊息肉腹腔镜手术患者的应激反应,缩短麻醉恢复时间,且对术后认知功能影响小。

Objective To explore the effects of general anesthesia combined with epidural block anesthesia on stress response,anesthesia recovery and postoperative cognitive function in laparoscopic surgery for gallbladder polyps.Methods According to the random sampling method,200 patients who underwent laparoscopic surgery for gallbladder polyps in our hospital were selected as the research objects,and the patients were divided into control group(100 cases,general anesthesia)and study group(100 cases,general anesthesia+epidural block anesthesia)by the random number table method.The anesthetic effects of the two groups were compared.Results At 5 min after tracheal intubation(T1),5 min after skin incision(T2),30 min of operation(T3)and 5 min after extubation(T4),the levels of AgⅡ,NE and IL-10 in the two groups were higher than those before anesthesia(T0),but those in the study group were significantly lower than the control group(P<0.05).The time of extubation,eye opening and awake in the study group were significantly shorter than those in the control group(P<0.05).On the 1st and 3rd day after operation,the MMSE score in the two groups were lower than those before operation,but those in the study group were significantly higher than the control group(P<0.05).Conclusion General anesthesia combined with epidural block anesthesia can reduce the stress response of patients undergoing laparoscopic surgery for gallbladder polyps,shorten the recovery time from anesthesia,and have little impact on postoperative cognitive function.