摘要
目的比较全麻联合连续硬膜外麻醉与间歇硬膜外麻醉在腹腔镜下子宫切除术中的应用效果。方法选取2020年10月至2021年10月接受腹腔镜下子宫切除术治疗的125例患者为研究对象,按照随机数字表法将其分为连续硬膜外组(62例)和间歇硬膜外组(63例)。连续硬膜外组采用连续硬膜外镇痛,间歇硬膜外组采用程控硬膜外间歇脉冲注入镇痛。比较两组的麻醉效果。结果术后4、8、24、48 h,间歇硬膜外组的视觉模拟评分法(VAS)评分及Ramsay镇静评分低于连续硬膜外组(P<0.05)。间歇硬膜外组的尿管留置时间、术后进食时间、术后下床时间、术后住院时间短于连续硬膜外组(P<0.05)。术后4、8、24、48 h,间歇硬膜外组的白细胞计数(WBC)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、C反应蛋白(CRP)及皮质醇水平低于连续硬膜外组(P<0.05)。间歇硬膜外组的不良反应总发生率低于连续硬膜外组(P<0.05)。结论相较于全麻联合连续硬膜外麻醉,全麻联合间歇硬膜外麻醉在腹腔镜下子宫切除术中的应用效果更佳,可为患者提供更优的镇痛、镇静效果,减少不良反应,减轻应激反应,加快术后康复。
Objective To compare the application effects of general anesthesia combined with continuous epidural anesthesia and intermittent epidural anesthesia in laparoscopic hysterectomy.Methods A total of 125 patients who underwent laparoscopic hysterectomy from October 2020 to October 2021 were selected as the study subjects.The patients were divided into continuous epidural group(62 cases)and intermittent epidural group(63 cases)according to the random number table method.The continuous epidural group received continuous epidural analgesia,and the intermittent epidural group received programmed epidural intermittent pulse injection for analgesia.The anesthetic effects of the two groups were compared.Results At 4,8,24,48 h after operation,the Visual Analogue Score(VAS)score and Ramsay sedation score of the intermittent epidural group were lower than those of the continuous epidural group(P<0.05).The catheter indwelling time,postoperative feeding time,postoperative ambulation time and postoperative hospital stay in the intermittent epidural group were shorter than those in the continuous epidural group(P<0.05).At 4,8,24 and 48 h after operation,the white blood cell count(WBC),free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),C-reactive protein(CRP)and cortisol levels in the intermittent epidural group were lower than those in the continuous epidural group(P<0.05).The total incidence of adverse reactions in the intermittent epidural group was lower than that in the continuous epidural group(P<0.05).Conclusion Compared with general anesthesia combined with continuous epidural anesthesia,general anesthesia combined with intermittent epidural anesthesia is more effective in laparoscopic hysterectomy.It can provide patients with better analgesic and sedative effects,reduce adverse reactions,alleviate stress response,and accelerate postoperative rehabilitation.
作者
高鹏
黄海燕
李翡
GAO Peng;HUANG Haiyan;LI Fei(Anesthesiology Department,No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000;Gynecology Department,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)
出处
《临床医学研究与实践》
2024年第13期68-71,共4页
Clinical Research and Practice
基金
2020年度陕西省教育厅一般专项项目(No.20JK0595)。
关键词
连续硬膜外麻醉
间歇硬膜外麻醉
腹腔镜子宫切除术
continuous epidural anesthesia
intermittent epidural anesthesia
laparoscopic hysterectomy
