两种麻醉方法对腹腔镜气腹的应激反应变化的作用

Stress response changes during laparoscopic cholecystectomy under general anesthesia or combination of general and epidural anesthesia

目的 观察全身麻醉和全麻复合硬膜外麻醉用于腹腔镜胆囊切除术 (LC)中CO2 气腹对血浆儿茶酚胺浓度的影响。方法 18例行腹腔镜胆囊切除患者 ,随机分成全麻组 (A组 ,10例 )和硬膜外 +全麻组 (B组 ,8例 ) ,采用高效液相色谱测定气腹前后血浆肾上腺素 (E)和去甲肾上腺素 (NE)浓度。结果 气腹时血浆肾上腺素 (E)和去甲肾上腺素 (NE)浓度A组均明显增加 (P <0 0 5 ) ,B组无明显变化 (P >0 0 5 )。结论 全麻复合硬膜外麻醉下施行腹腔镜胆囊切除术能减轻患者术中应激反应。

Objective To observe the concentration of plasma catecholamines changes during laparoscopic cholecystectomy (LC) under general anesthesia or combined with epidural anesthesia.Methods Eighteen patients for LC were randomly divided into general anesthesia group (A group, n =10) and general anesthesia combined with epidural anesthesia group (B group, n =8). The plasma concentration of epinephrine (E) and non-epinephrine (EN) were measured before and after CO2 being insufflated into peritoneal cavity with high performance liquid chromatography-electrochemical method.Results Both concentrations of E and NE were increased significantly after peritoneal insufflation in A group (P<0.05 ),while no obvious changes in B group (P>0.05).Conclusion The combination of general and epidural anesthesia. can suppress the stress response during LC.