妇科腹腔镜手术全麻复合硬膜外麻醉的临床应用效果

Clinical effect of general anesthesia combined with epidural anesthesia in gynecological laparoscopic surgery

目的:探讨全麻复合硬膜外麻醉在妇科腹腔镜手术中的应用效果。方法:选取某医院行妇科腹腔镜手术的90例患者,以随机数表法分为对照组与观察组,各45例患者,对照组患者接受常规全麻,观察组患者进行全麻复合硬膜外麻醉,记录患者诱导前(T0)、诱导中(T1)、诱导后(T2)、手术结束时(T3)的心率(HR)、收缩压(SBP)、舒张压(DBP),麻醉结束后自主呼吸恢复时间、拔管时间、清醒时间、丙泊酚用量、瑞芬太尼用量、不良反应发生率。结果:观察组患者T1、T2、T3时刻的HR、SBP、DBP值低于对照组(P<0.05),观察组患者T0、T1、T2、T3时刻的HR、SBP、DBP值无明显差异(P>0.05),对照组患者T0、T1、T2、T3时刻的HR、SBP、DBP值对比,差异具有统计学意义(P<0.05);观察组患者自主呼吸恢复时间、拔管时间、清醒时间短于对照组(P<0.05),其丙泊酚用量、瑞芬太尼用量低于对照组(P<0.05);观察组患者不良反应发生率低于对照组(P<0.05)。结论:全麻复合硬膜外麻醉应用在妇科腹腔镜手术中具有显著的临床效果,相较于全麻,更能稳定患者生命体征,能够提高手术安全,缩短麻醉苏醒时间,减少临床不良反应的发生。

Objective:Analyze the application effect of general anesthesia compound epidural anesthesia in gynecological laparoscopic surgery.Methods:Ninety patients in our hospital who underwent gynecological laparoscopic surgery were selected.They were divided into the control group and the observation group by random selection method,45 cases respectively.The control group underwent conventional general anesthesia.The observation group underwent general anesthesia combined epidural anesthesia to record the patient's heart rate(HR),systolic pressure(SBP),diastolic pressure(DBP)before induction(T0),induction(T1),post-induction(T2),and at the end of surgery(T3).After anesthesia,the recovery time of autonomic respiratory recovery time,tube extraction time,wake-up time,propofol dosage,remifentanil dosage,and incidence of adverse reactions,angioactive drug dosage.Results:There was no statistical difference in the comparison of HR,SBP and DBP in the two groups at T0(P>0.05).The HR,SBP and DBP of the patients in the observation group at T1,T2 and T3 were lower than those in the control group(P<0.05),and the HR and SB in the observation group at T0,T1,T2 and T3.There is no significant difference in the comparison of P and DBP(P>0.05),and the comparison of HR,SBP and DBP in the control group at the time of T0,T1,T2 and T3 has a statistical difference(P<0.05);the observation group's spontaneous respiratory recovery time,extraction time and wakefulness time are shorter than that of the control group(P<0.05)The dosage of propofol and remifentanil was lower than that of the control group(P<0.05);the incidence of adverse reactions was lower than that of the control group(P<0.05);the dosage of athrepine and ephedrine in the observation group was lower than that of the control group(P<0.05).Conclusion:General anesthesia combined epidural anesthesia has a significant clinical effect in gynecological laparoscopic surgery.Compared with general anesthesia,it can stabilize the vital signs of patients,improve the safety of surgery,ensure the surgical effect,shorten the awakening time of anesthesia,and reduce the occurrence of adverse clinical adverse reactions.