全麻复合硬膜外麻醉在腹腔镜直肠癌根治术中应用的研究
麻醉,全身·麻醉,硬膜外·腹腔镜·结直肠外科手术,,麻醉，全身·麻醉，硬膜外·腹腔镜·结直肠外科手术,【摘要】,【关键词】,1资料与方法,2结
【摘要】目的：评价全麻复合硬膜外麻醉在腹腔镜直肠癌根治术中的应用效果及安全性。方法：40例ASAⅠ~Ⅱ级择期行腹腔镜直肠癌根治术的病人，随机分为A组和B组各20例。A组为全麻复合硬膜外麻醉组，B组为单纯全麻组，分别观察两组病人手术期血流动力学变化、血气变化及全麻药用量。结果：两组病人手术期各时段HR、MAP变化A组均较B组轻且平稳；两组病人血气分析PaO2、HCO3均明显高于术前(P<0.01)，但两组无明显差异；A组全麻药用量明显小于B组(P<0.01)。结论：全麻复合硬膜外麻醉用于腹腔镜直肠癌根治术较单纯应用全身麻醉，全麻药用量明显减少，循环呼吸功能平稳，且便于术后镇痛。【关键词】麻醉，全身·麻醉，硬膜外·腹腔镜·结直肠外科手术
General combined with epidural anesthesia for laparoscopicassisted rectectomy
SHI Bin1,ZHANG Lei2
1Department of Anesthesiology,Linyi Turmor Hospital(Shandong 276001,China)
2Department of Ultrasonography,Linyi People’s Hospital(Shandong 276001,China)
【ABSTRACT】Objective:To evaluate the safety and efficacy of laparoscopicassisted rectectomy under combined general and epidural anesthesia.Methods:Forty ASA Ⅰ~Ⅱ patients scheduled for selective laparoscopicassisted rectectomy were randomly divided into two groups:group A and group B.Group A received combined general and epidural anesthesia and group B received general anesthesia only.Hemodynamics changes,PaO2 HCO-3 and anesthetic doses were observed preoperation,perioperation and postoperation.Results:The changes of HR,MAP in group A were lower than that of group B.PaO2,HCO3 were significantly higher than that of preoperation(P<0.01),but there were no significant difference between the two groups.The anesthetic doses of group A were significantly lower than that of gorup B(P<0.01).Conclusion:Comparing to general anesthesia,combined general and epidural anesthesia can significantly reduce the anesthetic doses,use PECA conveniently and have no significant reverse effect on circulation and respiratory.So combined general and epidural anesthesia is the best choice for laparoscopicassisted rectectomy. ......
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