腰硬联合麻醉复合静脉全身麻醉在妇产科腹腔镜手术中的应用分析

Application Analysis of Spinal Epidural Anesthesia Combined with Intravenous General Anesthesia in Laparoscopic Surgery of Obstetrics and Gynecology

目的研究妇产科腹腔镜手术中实施腰硬联合麻醉复合静脉全身麻醉的价值。方法选取2020年1月-2022年6月本院收治的140例接受腹腔镜手术治疗的患者为研究对象,基于麻醉方式划分两个小组,即70例患者接受静脉全身麻醉为全身麻醉组、剩余70例患者接受腰硬联合麻醉复合静脉全身麻醉为复合麻醉组,分析两组患者病情变化,记录患者手术之中的多个指标数据。结果麻醉之前,全身麻醉组与复合麻醉组患者的血流动力学指标对比(P>0.05)。而复合麻醉组人工在构建人工气腹之后十分钟时平均动脉压指数、心率指数,在解除人工气腹之后10min时平均动脉压、心率指数均优于全身麻醉组(P<0.05);复合麻醉组患者丙泊酚药物剂量、阿曲库铵药物剂量、手术清醒平均时间、拔管时间平均指数均优于全身麻醉组(P<0.05);麻醉之前,全身麻醉组与复合麻醉组患者的应激项目指标对比(P>0.05)。而复合麻醉组人工在构建人工气腹之后10min时血糖指数、去甲肾上腺素指数,在解除人工气腹之后10min时血糖指数、去甲肾上腺素指数均优于全身麻醉组(P<0.05);复合麻醉组不良总出现率小于全身麻醉组(P<0.05)。结论针对妇产科腹腔镜手术治疗中,引进腰硬联合麻醉复合静脉全身麻醉的成效比较显著,可有效调整患者血流动力学指标与应激反应,还可以减少患者出现不良反应概率,值得推广。

Objective To study value of spinal epidural anesthesia combined with intravenous general anesthesia in laparoscopic surgery of obstetrics and gynecology.Methods The paper chose 140 patients with laparoscopic surgery from January 2020 to June 2022,and divided them into two groups based on the anesthesia method:70 cases in general anesthesia group were treated with intravenous general anesthesia,and 70 cases in combined anesthesia group with combined spinal epidural anesthesia and intravenous general anesthesia.Condition changes between two groups were analyzed,and multiple indicator data during surgery were recorded.Results Hemodynamic indicators comparison between general anesthesia group and combined anesthesia group before anesthesia showed P>0.05.Average arterial pressure index and heart rate index of combined anesthesia group at 10 minutes after construction of artificial pneumoperitoneum were better than general anesthesia group at 10 minutes after release of artificial pneumoperitoneum(P<0.05).Dosage of propofol,atracurium,average time of surgical awakening,average index of extubation time in combined anesthesia group was better than general anesthesia group(P<0.05).Stress indicators comparison between general anesthesia group and conbined anesthesia group before anesthesia showed P>0.05.Blood glucose index and norepinephrine index of combined anesthesia group were higher than general anesthesia group at 10 minutes after construction of artificial pneumoperitoneum,and at 10 minutes after release of artificial pneumoperitoneum(P<0.05).Total incidence of adverse reactions in combined anesthesia group was lower than general anesthesia group(P<0.05).Conclusion In treatment of laparoscopic surgery in obstetrics and gynecology,lumbar epidural anesthesia combined with intravenous general anesthesia can achieve significant effect,can adjust patient hemodynamic indicators and stress reactions effectively,and reduce incidence of adverse reactions of patients,which is worthy of promotion.