| 摘要: |
| 目的探讨全麻复合硬膜外麻醉在妇科腹腔镜手术中的效果及对血流动力学的影响。方法选取拟行择期腹腔镜手术的妇科患者126例，按随机数字表法分全麻组（A组）和全麻复合硬膜外麻醉（B组），每组63例。记录两组患者二氧化碳气腹前（T1）、气腹后10min（T2）、30min（T3）、拔管后5min（T4）的SBP、DBP、HR、MAP、SpO2以及子宫松弛度等级、全麻用药量、手术时间、术后苏醒时间。结果B组T2、T3、T4时SBP、DBP、HR、MAP均低于A组（均P＜0.05）。A、B组子宫松弛度优良率分别为69.84%、93.65%，B组高于A组（P＜0.05）。B组丙泊酚、瑞芬太尼、阿曲库铵消耗量均少于A组（均P＜0.05），手术时间、术后苏醒时间均短于A组（均P＜0.05或0.01）。结论全麻复合硬膜外麻醉在妇科腹腔镜手术中具有较好的麻醉效果，患者血流动力学比较稳定。 |
| 关键词: 腹腔镜 麻醉 血流动力学 协同作用 |
| DOI： |
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| Anesthetic effect of general anesthesia combined with epidural anesthesia in laparoscopic gynecologic surgery and its influence on hemodynamics |
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CHEN Hongfu, ZHANG Ruidong, GAO Baobin
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Zhoushan Maternal and Child Health Hosptial
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| Abstract: |
| Objective To assess the anesthetic effect of general anesthesia combined with epidural anesthesia in laparoscopic gynecologic surgery and its influence on hemodynamics. Methods One hundred and twenty six gynecology patients undergoing elective laparoscopic surgery were randomly assigned to receive general anesthesia (group A, n=63) or general anesthesia combined with epidural anesthesia (group B, n=63). Hemodynamic parameters in two groups were compared, including SBP, DBP, HR, MAP, SpO2, before CO2 pneumoperitoneum(T1), 10min after pneumoperitoneum (T2), 30min after pneumoperitoneum (T3), 5 min after extubation(T4). The uterus laxity grade, consumption of anesthetics, operation time and
postoperative recovery time were documented and compared in two groups. Results SBP, DBP, HR, MAP on T2, T3, T4 in group B were all lower than those in group A (P＜0.05). Uterus laxity excellent rates in group A and B were 69.84% and 93.65% (P＜0.05). Consumption of propofol, remifentanil and atracurium in group B was less and operative time, postoperative recovery time were shorter than those in group A (P ＜0.05 or P ＜0.01). Conclusion General anesthesia combined with epidural
anesthesia provides satisfactory anesthesia effect with stable hemodynamics of patients in laparoscopic gynecologic surgery. |
| Key words: Laparoscopy Anesthesia Hemodynamics Synergy |
