【摘要】 目的:比较硬膜外联合全身麻醉与单纯全身麻醉在游离皮瓣乳房重建术中的有效性以及安全性。方法:收集采用硬膜外联合全身麻醉(联合组,n=55)和单纯全身麻醉(全麻组,n=60)进行游离皮瓣乳房重建术患者的资料。回顾分析术后并发症、疼痛视觉模拟评分(visual analogue scale,VAS)以及术后恶心、呕吐的发生率。结果:联合组和全麻组皮瓣血栓发生率分别为3.6%和3.3%(P=1.000)。联合组和全麻组的皮瓣坏死发生率分别为0%和3.3%(P=0.497)。联合组的VAS评分在术后0~2h(0.75±0.62比2.31±1.04,P<0.001)、2~6h(1.90±1.18比3.68±1.50,P<0.001)和6~24h(0.71±0.70比1.34±0.99,P=0.001)均低于全麻组。联合组术后恶心、呕吐发生率低于全麻组(P<0.05)。结论:在游离皮瓣乳房重建术中采用硬膜外联合全身麻醉可减轻术后疼痛,改善术后恶心、呕吐,并且对皮瓣存活无明显影响。更多还原

【Abstract】 Objective:To compare the efficacy and safety between combined epidural/general anesthesia and general anesthesia in free flap breast reconstruction.Methods:The data of patients,who underwent free flap breast reconstruction under combined epidural/general anesthesia(EA/GA group,n=55)or general anesthesia(GA group,n=60),were collected.The postoperative complications,pain assessment with visual analogue scale(VAS),and incidence of postoperative nausea and vomiting(PONV)were retrospectively analyzed.Results:The incidence of flap thrombosis was 3.6%in the EA/GA group while it was 3.3%in the GA group(P=1.000).And the incidence of flap failure was 0%in the EA/GA group,while it was 3.3% in the GA group(P=0.497).Compared with that in the GA group,patients in the EA/GA group experienced lower VAS scores at 2h(0.75±0.62 vs 2.31±1.04,P<0.001),6h(1.90±1.18 vs 3.68±1.50,P<0.001)and 24h(0.71±0.70 vs 1.34±0.99,P=0.001)postoperatively.Furthermore,the incidence of PONV in the EA/GA group was significantly lower than that in the GA group(P<0.05).Conclusions:Combined epidural/general anesthesia can relieve postoperative pain and PONV without affecting flap survival in patients undergoing free flap breast reconstruction.更多还原