Comparison of the Application of Opiate-free General Anesthesia Combined with Thorac-ic Epidural Anesthesia and Conventional General Anesthesia in Radical Gastrectomy
Objective To compare and analyze the effect of non-opioid general anesthesia combined with thoracic epi-dural anesthesia(TEA)and conventional general anesthesia in radical gastrectomy of gastric cancer.Methods A total of 92 pa-tients who underwent radical gastrectomy were selected as the research objects,and were divided into the study group and the con-trol group by random number table method,46 patients in each group.Both groups received laparoscopic radical gastrectomy.The control group received conventional general anesthesia(Sufentanil+propofol+etomidate+rocuronium bromide+midazolam),while the study group received opiate-free general anesthesia(propofol+etomidate+rocuronium bromide+midazolam+ropiva-caine)combined with TEA.The perioperative indexes,heart rate(HR),mean arterial pressure(MAP),Ramsay score,Prince-Hen-ry score and anesthesia recovery index,postoperative gastrointestinal recovery and incidence of adverse reactions were compared between the2 groups after 1min of intubation(T0),5min after cuticulation(T1),wound suture completion(T2)and extubation(T3).Results The anesthesia time of the study group was shorter than that of the control group,and the amount of propofol was less than that of the control group(P＜0.05).HR and MAP at T1,T2 and T3 were not significantly different from those at T0(P＞0.05).HR and MAP of control group at T1,T2 and T3 were significantly different from those at T0(P＜0.05).HR and MAP of the study group at T1,T2 and T3 were lower than those of the control group(P＜0.05).Ramsay score of the study group at T1,T2 and T3 was higher than that of the control group,Prince-Henry score was lower than that of the control group(P＜0.05).The re-covery time,extubation time,first anal exhaust time,first getting out of bed time and hospitalization time of the study group were shorter than those of the control group(P＜0.05).The incidence of postoperative adverse reactions was 6.52%in the study group,which was significantly lower than 21.74%in the control group(P＜0.05).Conclusion Compared with conventional general anesthesia,general anesthesia without opioid combined with TEA can stabilize perioperative hemodynamics in patients un-dergoing radical gastrectomy,improve sedation,analgesia and quality of anesthesia recovery,and promote postoperative gastrointes-tinal function recovery with good safety.
Routine general anesthesiaGeneral anesthesia without opioidsThoracic epidural anesthesiaHemodynam-icsGastrointestinal function
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