腹腔镜胆囊手术不同麻醉临床效果分析

Analysis of Clinical Effects of Different Anesthesia in Laparoscopic Gallbladder Surgery

目的探讨腹腔镜胆囊手术中采用两种不同麻醉方式的临床应用效果。方法方便选取2017年8月—2019年8月该院收治的150例胆囊手术患者作为该次所要研究的对象,并根据不同麻醉方式将其分成对照组和观察组,各75例。对照组患者采用静吸复合麻醉,观察组患者采用静吸复合麻醉联合硬膜外麻醉,分析两组患者麻醉效果。结果观察组患者在气腹前、气腹期间以及术毕放气后的变化情况与对照组相比较明显,差异有统计学意义(P<0.05);观察组患者麻醉后唤醒时间(8.2±2.6)min与对照组(15.4±4.6)min相比较低,其躁动发生率17.3%显著较低于对照组45.3%,差异有统计学意义(t=11.800,χ^(2)=13.664,P<0.05);观察组患者麻醉手术期间的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)均较优于对照组,差异有统计学意义(P<0.05)。结论腹腔镜手术中采用硬膜外麻醉联合静吸符合麻醉方式能显著改善患者在手术中出现的应激反应,同时静吸符合麻醉的药量显著减少,因此患者麻醉后的苏醒时间减短、呼吸稳定,降低并发症,临床值得推广并应用。

Objective To explore the clinical application effects of two different anesthesia methods in laparoscopic gallbladder surgery.Methods 150 cases of gallbladder surgery patients admitted to the hospital from August 2017 to August 2019 were conveniently selected as the subjects of this study,and were divided into a control group and an observation group with 75 cases according to different anesthesia methods.Patients in the control group were treated with combined intravenous inhalation anesthesia,and patients in the observation group were treated with combined intravenous inhalation anesthesia combined with epidural anesthesia.The anesthesia effects of the two groups were analyzed.Results The changes in observation group before pneumoperitoneum,during pneumoperitoneum and after deflation after operation were more obvious than those in control group,and the difference was statistically significant(P<0.05);observation group patients woke up time after anesthesia(8.2±2.6)min is lower than the control group(15.4±4.6)min,and its agitation rate was 17.3%significantly lower than that of the control group 45.3%,the difference was statistically significant(t=11.800,χ^(2)=13.664,P<0.05);heart rate(HR),mean arterial pressure(MAP)and blood oxygen saturation(SpO2)of the patients during anesthesia surgery were better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The use of epidural anesthesia combined with intravenous inhalation in laparoscopic surgery can significantly improve the patient's stress response during the operation,and at the same time,the amount of intravenous inhalation in accordance with anesthesia is significantly reduced,so the patient's recovery time after anesthesia is shortened.Respiration is stable and complications are reduced.It is clinically worthy of promotion and application.