摘要
目的观察两点法腰麻-硬膜外联合阻滞麻醉和全身麻醉用于腹腔镜腹股沟疝修补术对血浆肾上腺素、去甲肾上腺素及血流动力学的影响。方法42例拟行腹腔镜经腹腔腹膜前网片腹股沟疝修补术患者随机分为两组:两点穿刺法腰麻-硬膜外联合麻醉(CSEA)组和全麻(GA)组,每组21例。监测麻醉前,手术开始前即刻,气腹后5min、30min,术毕30min各时点血浆NE、E浓度并记录HR、MAP值。结果CSEA组各时点NE浓度无明显改变,手术开始前即刻及气腹后E明显增高(P<0.05),术后30min基本恢复;GA组气腹后NE及E均明显增加(P<0.05),术后30min仍未恢复。手术开始前即刻CSEA组HR高于GA组(P<0.05),气腹后CSEA组HR、MAP低于GA组。结论腰麻-硬膜外联合麻醉较全身麻醉能较好地抑制腹腔镜腹股沟疝修补术的应激反应。
Objective To study the different effect of laparoscopic mesh repair of inguinal hernia operation between combined spinal and epidural anesthesia and general anesthesia on adrenalin(E) and noradrenalin(NE) in serum and blood dynamics.Methods 42 patients to be operated by transabdominal preperitoneal laparoscopic mesh repair of inguinal hernia were divided into two groups randomly (group CSEA and group GA),21patients in each group. NE and E in serum and HR, MAP were monitored at the moment before anesthesia and before operation ,5 and 30 minutes after artifactitious carbon dioxide abdomen , and 30minutes after operation . Results The E concentration at the moment after operation and aritifactitious carbon dioxide abdomen is increased obviously (P<0.05) and it is basically normal at 30minutes after operation, there is not any change of NE at each time point in CSEA group. The concentration of E and NE is increased obviously (P<0.05) after artifactitious carbon dioxide abdomen and it does not recur at 30 minutes after operation in GA group. The HR in CSEA is higher than the one in GA group at moment before operation (P<0.05),HR and MAP in group CSEA are lower than those in group GA after artifactitious carbon dioxide abdomen. Conclusions The stress can be inhabited better during laparoscopic mesh repair of inguinal hernia operatin with combined spinal and epidural anesthesia than with general anesthesia .
出处
《中国医药导报》
CAS
2006年第23期71-72,共2页
China Medical Herald
关键词
腰麻
硬膜外麻醉
应激反应
腹腔镜
腹股沟疝修补术
spinal Anesthesia
Epidural Anesthesia
Spinal cord
Stress
Laparoscopic
Mesh repair of inguinal hernia
