硬膜外阻滞复合全身麻醉在腹腔镜子宫切除术中的应用研究
Application of Epidural Block Combined with General Anesthesia in Lapa-roscopic Hysterectomy
刘彤 1林威威 1陈本祯 2陈东文 1阳旭 1高洪光 1周龑 3鄢伟4
作者信息
- 1. 611730 成都,成都医学院第三附属医院·成都市郫都区人民医院麻醉科
- 2. 610045 成都,四川省妇幼保健院麻醉科
- 3. 610044 成都,四川大学华西第四医院麻醉科
- 4. 266033 山东 青岛,青岛市中医医院 市海慈医院神经外科
- 折叠
摘要
目的 分析硬膜外阻滞复合全身麻醉在宫颈癌腹腔镜子宫切除术中的应用效果及对疼痛、应激指标的影响.方法 选取2018 年2 月—2021 年4 月收治宫颈癌行腹腔镜子宫切除术者 122 例,按麻醉方式不同分为A组(全身麻醉)60 例和B组(硬膜外阻滞复合全身麻醉)62 例.对比2 组麻醉效果、麻醉相关时间、疼痛情况、平均动脉压(MAP)、心率、去甲肾上腺素(NE)、肾上腺素(E)及不良反应发生情况.结果 B 组麻醉效果优于 A 组(P＜0.05).B组恢复自主呼吸、拔管、苏醒时间均短于 A 组,视觉模拟评分法评分低于 A 组(P＜0.01).2 组气腹后MAP、心率、NE、E水平均较麻醉前升高,但B组低于A组(P＜0.05,P＜0.01);术毕时,B组MAP、心率、NE、E水平低于A组(P＜0.01).B组不良反应发生率(4.84%,3/62)低于A组(16.67%,10/60)(P＜0.05).结论 硬膜外阻滞复合全身麻醉在宫颈癌腹腔镜子宫切除术中的应用效果显著,可缓解疼痛,减轻术后应激反应,且安全性高.
Abstract
Objective To analyze the application effect of epidural block combined with general anesthesia in laparo-scopic hysterectomy for cervical cancer and its effects on pain and stress indexes.Methods A total of 122 patients who un-derwent laparoscopic hysterectomy for cervical cancer from February 2018 to April 2021 were selected and divided into group A(receiving general anesthesia,n =60)and group B(receiving epidural block+general anesthesia,n =62)according to dif-ferent anesthesia methods.Anesthetic effect,anesthesia related time,pain,mean arterial pressure(MAP),heart rate(HR),norepinephrine(NE),epinephrine(E)and adverse reactions were compared between the two groups.Results The anesthetic effect of group B was higher than that of group A(P＜0.05).The recovery time of spontaneous breathing,extuba-tion and recovery time of group B were shorter than those of group A,and the visual analog scale(VAS)score of group B was lower than that of group A(P＜0.01).After pneumoperitoneum,the levels of MAP,HR,NE and E in the two groups were higher than those before anesthesia,but lower in group B than in group A(P＜0.05,P＜0.01).After the operation,the MAP,HR,NE and E levels in group B were lower than those in group A(P＜0.01).The incidence of adverse reactions in group B was lower than that in group A[(4.84%,3/62)vs.(16.67%,10/60)](P＜0.05).Conclusion Epidural block combined with general anesthesia in laparoscopic hysterectomy for cervical cancer has a significant effect,which can re-lieve pain,and reduce postoperative stress reaction,showing good safety.
关键词
宫颈肿瘤/麻醉,硬膜外/全身麻醉/腹腔镜/子宫切除术/疼痛/去甲肾上腺素/肾上腺素Key words
Uterine cervical neoplasms/Anesthesia,epidural/General anesthesia/Laparoscopes/Hysterectomy/Pain/Norepinephrine/Epinephrine引用本文复制引用
基金项目
四川省卫生健康委员会科研课题(19ZD009)
出版年
2023
国家科技期刊平台
NSTL
万方数据