罗哌卡因硬膜外麻醉复合全身麻醉在腹部手术中的应用效果分析

Analysis on Application Effect of Ropivacaine Epidural Anesthesia Combined with General Anesthesia in Abdominal Surgery

目的:分析罗哌卡因硬膜外麻醉复合全身麻醉在腹部手术中的应用效果。方法:选取2021年1月—2023年8月于如皋市第四人民医院接受腹部手术的患者90例作为研究对象,随机分为对照组及研究组,各45例。对照组采取全身麻醉,研究组采取罗哌卡因硬膜外麻醉复合全身麻醉。比较两组麻醉效果。结果:麻醉前(T_0),两组心率、平均动脉压、收缩压及舒张压比较,差异无统计学意义(P>0.05);切皮时(T_1)、气腹后即刻(T_2)、结束气腹5 min(T_3),研究组心率、平均动脉压、收缩压及舒张压低于T_0及同期对照组,对照组收缩压及舒张压低于T_0;对照组T_1、T_2心率、平均动脉压高于T_0,T_3低于T_0,差异有统计学意义(P<0.05)。研究组术后苏醒时间、拔管时间早于对照组,术后15 min Aldrete苏醒评分高于对照组,差异有统计学意义(P<0.001)。研究组不良反应总发生率低于对照组,差异有统计学意义(P=0.007)。结论:罗哌卡因硬膜外麻醉复合全身麻醉在腹部手术中的应用效果较好,可稳定患者术中生命体征,促进苏醒及尽快拔管,安全性高。

Objective:To analyze the application effect of ropivacaine epidural anesthesia combined with general anesthesia in abdominal surgery.Methods:A total of 90 patients who underwent abdominal surgery at the Fourth People's Hospital of Rugao City from January 2021 to August 2023 were selected as the study subjects.They were randomly divided into a control group and a study group,with 45 cases in each group.The control group received general anesthesia,while the study group received ropivacaine epidural anesthesia combined with general anesthesia.The anesthesia effects of the two groups were compared.Results:Before anesthesia(T0),there was no significant difference in heart rate,mean arterial pressure,systolic blood pressure and diastolic blood pressure between the two groups(P>0.05);At skin incision(T1),immediately after pneumoperitoneum(T2)and 5 min after pneumoperitoneum ended(T3),the heart rate,mean arterial pressure,systolic blood pressure and diastolic blood pressure in the study group were lower than those at T0 and those in the control group during the same period,the systolic blood pressure and diastolic blood pressure in the control group were lower than those at T0;the heart rate and mean arterial pressure in the control group at T1 and T2 were higher than those at T0,and these indicators at T3 were lower than those at T0,with a statistically significant difference(P<0.05).The postoperative awakening time and extubation time in the study group were earlier than those in the control group,and the Aldrete awakening score at 15 min after surgery in the study group was higher than that in the control group,and the difference was statistically significant(P<0.001).The total incidence of adverse reactions in the study group was lower than that in the control group,and the difference was statistically significant(P=0.007).Conclusion:Ropivacaine epidural anesthesia combined with general anesthesia has a good application effect in abdominal surgery,and can stabilize the patient's intraoperative vital signs,promote the awakening and extubation,and have high safety.