摘要
目的探讨腰硬联合阻滞复合浅全身麻醉与插管全身麻醉在妇科腹腔镜手术中的麻醉效果及可行性。方法选择58例患者,分为腰-硬联合阻滞(A组)和插管全身麻醉(B组)各29例,分别记录气腹前、气腹后10、20、30min排气后10min的BP、HR、RR、SpO2、PETCO2,同时观察患者的反应及术后苏醒情况。结果A组CO2气腹后,RR加快、PETCO2升高差异有统计学意义(P<0.01),仍可维持正常范围,而SpO2变化差异无统计学意义(P>0.05);B组气腹时应激反应活跃,DBP、SBP、HR与气腹前比较差异有统计学意义(P<0.01),两组患者在气腹30min后,各项指标均有所改善,排气后10min各项指标与气腹前比较差异无统计学意义(P>0.05),A组比B组术后苏醒快差异有统计学意义(P<0.01),所有患者均顺利完成手术,未发生麻醉并发症。结论在妇科腹腔镜手术中,应用腰-硬联合阻滞复合浅全身麻醉比插管全身麻醉能更好地控制机体的应激反应,术后苏醒快,是一种效果佳、可行、实用的麻醉方法。
Objective To discuss the anaesthesia effect and its feasibility of CSEA assisted by the shallow and general vein anesthesia and the pure tube-inserting general anesthesia in the gynecology peritoneoscope surgery. Methods To choose 58 eases of patients, stochastically divide them into the CSEA group （group A） and tube-inserting general anesthesia group （ group B ）, with 29 cases in each group, then separately monitor and record their DBP,SBP,HR,RR,SpO2 ,PETCO2 10,20,30 minutes before and after pneumoperitoneum and 10 minutes after exhausting, then observe the response of the 2 groups of patients after pneumoperitoneum and conseiousness-regaining situation after surgery. Results After CO2 pneumoperitoneum, RR of the patients in group A speeds up,their PETCO2 elevates obviously （P 〈 0. 01 ） ; the response of the patients in group B becomes active when pneumoperitoneum, the change of DBP, SBP, HR is more remarkable than that before pneumoperitoneurn（ P 〈0.01 ）. Each target of the two groups of patients has been improved 30 minutes after pneumoperitoneurn. Each target is quite close to that before pneumoperitoneum 10 min after exhausting. The consciousness of the patients in group A regains more quickly compared to those in group B after the surgery（ P 〈 0. 01 ）. All the gynecology peritoneoseope surgery to the patients has been smoothly done, no anaesthesia complication or accidents have happened. Conclusions In the gynecology peritoneoscope surgery, the method of CSEA assisted by the shallow and general vein anesthesia can more easily control the response of the organism compared to the method of tube-inserting general anesthesia. The consciousness can be regained quickly after surgery through the method. It is an effective, feasible and practical anaesthesia method.
出处
《中国实用医药》
2008年第35期22-23,共2页
China Practical Medicine
关键词
腰-硬联合阻滞麻醉
全身麻醉
妇科手术
腹腔镜
Combined spinal epidural analgesia （CSEA）
General anesthesia
Gynecology surgery
Per- itoneoscope
