【摘要】 目的 :比较全麻联合硬膜外阻滞和单纯全麻用于腹腔镜手术的临床效果。方法 :30例拟行选择性腹腔镜手术患者随机分为全麻组 (A组 ,15例 )和全麻联合硬膜外阻滞组 (B组 ,15例 )。术中连续监测HR ,BP和气道压 ;测定患者麻醉前、气腹前、气腹后 2 0min及术毕拔除气管导管后 5min 4个时点的血糖浓度 ;观察并记录两组病人的术后唤醒时间及术后躁动发生率。结果 :与B组比较 ,A组在气腹期间和拔管时平均动脉压及HR均显著增加 (P <0 .0 5 )。气腹时两组气道压及血糖水平均有所升高 ,但A组升高较明显 (P <0 .0 5 )。B组病人术后唤醒时间短 ,躁动发生率低 ,与A组比较差异显著 (P <0 .0 5 ,P <0 .0 1)。结论 :全麻联合硬膜外阻滞较单纯全麻用于腹腔镜手术的应激反应轻 ,术后清醒快且术后躁动发生率低 ,是一较理想的麻醉方法。更多还原

【Abstract】 Objective: To compare the clinical effect of single general anesthesia with combined general epidural anesthesia used for laparoscopic surgery.Methods:Thirty patients scheduled for select laparoscopic surgery who were randomly divided into general anesthesia group(GroupA, n =15) and general anesthesia combined with epidural block group (GroupB, n =15). HR、BP and airway pressure were continuously monitored.The concentration of blood glucose were determined at the following four time points:before anesthesia and insufflation,at 20min after pneumoperitoneum and at 5min after detubation .postoperative awakening time and postoperative restlessness were observed and recorded. Results: compared with Group B,MAP and HR were increased significantly ( P <0.05),during pneumoperitoneum and at detubation in Group A. Airway pressure and the level of blood glucose were both increased in two groups during pneumoperitoneum, but there was a obvious increase in Group A ( P <0.05).postoperative awakening time was short and the incidence of postoperative restlessness was low in Group B ,there were markedly difference between two groups ( P<0.05, P <0.01).Conclusion:General anesthesia combined with epidural block may alleviate stress response, shorten postoperative awake time and diminish the incidence of postoperative restlessness, therefore it is an ideal technique for Laparoscopic surgery.更多还原