全身麻醉联合硬膜外麻醉在腹腔镜下直肠癌根治术中的效果

Effect of General Anesthesia Combined with Epidural Anesthesia in Laparoscopic Radical Resection of Rectal Cancer

目的:分析全身麻醉联合硬膜外麻醉在腹腔镜下直肠癌根治术中的效果。方法:选取2021年4月—2022年4月在建瓯市立医院治疗的80例直肠癌患者。按照随机分组原则,将其分为两组,各40例。两组均接受腹腔镜下直肠癌根治术治疗,对照组应用全身麻醉方案,在此基础上,观察组联合硬膜外麻醉方案。比较两组的血流动力学[心率(HR)、平均动脉压(MAP)]指标、氧合指标[动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))]、麻醉恢复情况、麻醉药物剂量及不良反应发生情况。结果:入室后(T_0)、气管插管后10 min(T_1)、关气腹10 min(T_3),两组HR、MAP比较,差异无统计学意义(P>0.05),T_0,两组PaO_(2)、SpO_(2)比较,差异无统计学意义(P>0.05);气腹建立1 h(T_(2))、拔管时(T_4),观察组HR、MAP均低于对照组,PaO_(2)、SpO_(2)均高于对照组,差异有统计学意义(P<0.05)。观察组拔管时间、睁眼时间均早于对照组,差异有统计学意义(P<0.05)。观察组丙泊酚、瑞芬太尼、顺阿曲库铵等剂量低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为12.50%,低于对照组的32.50%,差异有统计学意义(P<0.05)。结论:复合麻醉方案能够维持血流动力学稳定,改善氧合功能,促进其麻醉恢复,减少麻醉药物剂量,降低不良反应发生率。

Objective:To analyze the effect of general anesthesia combined with epidural anesthesia in laparoscopic radical resection of rectal cancer.Method:A total of 80 patients with rectal cancer treated in Jian’ou Municipal Hospital from April 2021 to April 2022 were selected.According to the principle of random grouping,they were divided into two groups,40 cases in each group.Both groups received laparoscopic radical resection of rectal cancer,the control group was given general anesthesia,and the observation group was given epidural anesthesia on this basis.The hemodynamics indexes[heart rate(HR),mean arterial pressure(MAP)],oxygenation index[oxygenation index(PaO_(2)),oxygen saturation(SpO_(2))],anesthesia recovery,anesthetic drug dosage and adverse reactions were compared between the two groups.Result:After entry(T0),10 min after tracheal intubation(T1),and 10 min after pneumoperitoneum(T3),there were no significant differences in HR and MAP between the two groups(P>0.05),and at T0,there were no significant differences in PaO_(2) and SpO_(2) between the two groups(P>0.05).At pneumoperitoneum was established 1 h(T2)and extubation(T4),HR and MAP in the observation group were lower than those in the control group,while PaO_(2) and SpO_(2) were higher than those in the control group,the differences were statistically significant(P<0.05).The extubation time and eye opening time in the observation group were earlier than those in the control group,and the differences were statistically significant(P<0.05).The doses of Propofol,Remifentanil and Cisatracurium in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence rate of adverse reaction in the observation group was 12.50%,which was lower than 32.50%in the control group,the difference was statistically significant(P<0.05).Conclusion:Combined anesthesia regimen can maintain hemodynamic stability,improve oxygenation function,promote anesthesia recovery,reduce anesthetic drug dose,and reduce the incidence of adverse reactions.