全麻复合硬膜外麻醉用于腹腔镜下子宫肌瘤切除术的效果研究

The Effect of General Anesthesia Combined with Epidural Anesthesia in Laparoscopic Myomectomy

目的分析全麻复合硬膜外麻醉用于腹腔镜下子宫肌瘤切除术的效果。方法方便选择该院2019年1月—2020年1月腹腔镜下子宫肌瘤切除术患者共70例,数字表随机分两组,每组35例。对照组的患者给予单纯全身麻醉,观察组采取全麻复合硬膜外麻醉。比较两组手术时间和术后苏醒时间,丙泊酚、顺阿曲库铵用量,手术前、手术切皮时、气腹后20 min、术毕患者平均动脉压和心率。结果观察组手术时间和术后苏醒时间、丙泊酚、顺阿曲库铵用量(86.21±5.21)min、(11.19±2.51)min、(76.21±9.21)mg、(6.19±1.51)mg低于对照组(124.56±12.91)min、(21.25±3.18)min、(189.56±12.91)mg、(10.25±3.18)mg,差异有统计学意义(t=16.300、14.690、42.290、6.823,P<0.05)。治疗前两组患者平均动脉压和心率比较差异无统计学意义(P>0.05),而手术切皮时、气腹后20 min、术毕两组平均动脉压和心率均有所升高,而观察组平均动脉压和心率显著低于对照组,差异有统计学意义(P<0.05)。结论全麻复合硬膜外麻醉用于腹腔镜下子宫肌瘤切除术的效果确切,可维持患者术中生命体征稳定,缩短手术时间,减少麻醉药物用量。

Objective To analyze the effect of general anesthesia combined with epidural anesthesia for laparoscopic myomectomy.Methods A total of 70 patients undergoing laparoscopic myomectomy in the hospital from January 2019 to January 2020 were conveniently selected.The number table was randomly divided into 2 groups with 35 cases in each group.Patients in the control group were given simple general anesthesia,and the observation group was taken general anesthesia combined with epidural anesthesia.The operation time and postoperative wake-up time,the dosage of propofol,cisatracurium,preoperative,surgical incision,20 min after pneumoperitoneum,mean arterial pressure and heart rate of patients were compared between the two groups.Results The operation time and postoperative wake-up time of the observation group,the dosage of propofol and cisatracurium(86.21±5.21)min,(11.19±2.51)min,(76.21±9.21)mg,(6.19±1.51)mg were lower than those of the control group(124.56±12.91)min,(21.25±3.18)min,(189.56±12.91)mg,(10.25±3.18)mg,and the difference was statistically significant(t=16.300,14.690,42.290,6.823,P<0.05).Before treatment,the average arterial pressure and heart rate of the two groups of patients were compared,and the difference was not statistically significant(P>0.05),while the average arterial pressure and heart rate of the two groups increased during skin incision,20 min after pneumoperitoneum,and after the operation,while the average arterial pressure and heart rate of the observation group increased.The heart rate was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion General anesthesia combined with epidural anesthesia is effective for laparoscopic myomectomy.It can maintain the patient's vital signs during the operation,shorten the operation time,and reduce the amount of anesthetic drugs.