快通道全身麻醉与硬膜外麻醉用于泌尿外科内镜手术的比较

【作者】 肖静； 罗放；

【机构】 华中科技大学同济医学院附属同济医院麻醉科；

【摘要】 目的比较快通道全麻与硬膜外麻醉用于泌尿外科内镜手术的术床周转率及麻醉不良事件。方法选择择期行泌尿外科内镜手术的患者135例,平均分为三组:A组:连续硬膜外麻醉组,B组:无肌松喉罩快通道全身麻醉组,C组:气管插管快通道全身麻醉组。记录麻醉前、硬膜外腔注药/全麻醉插管即刻、手术结束时MAP,术中平均HR,术中使用血管活性药物的例数,记录麻醉操作时间,手术时间以及麻醉期不良反应以及并发症。结果三组间血压及心率变化无统计学差异。B组(8.20±3.48 min)和C组(8.76±3.69 min)麻醉操作时间明显短于A组(24.24±7.27 min),(P<0.01)。A组麻醉不良事件发生率(17.8%)较B组(2.2%)和C组(4.4%)高(P<0.01);各组手术时间无明显差异。结论与连续硬膜外麻醉相比,快通道全身麻醉用于泌尿外科腔镜手术具有术床周转率高,麻醉并症少的优势。更多还原

【Abstract】 Objective To compare the rate of operating table turnover and adverse reactions and complications of anesthesia between Fast-track general anesthesia and epidural anesthesia forurological endoscopic surgery. Methods 135 patients who undergoing elective urological endoscopic surgery were divided into three groups. Group A: continuous epidural anesthesia group. Group B: laryngeal mask fast track general anesthesia group without muscle relaxant. Group C: endotracheal intubation fast track general anesthesia. The MAP before anesthesia, at the time of epidural injectionor intubation and at the end of the surgery were recorded; also we recorded the average HR during operation, the number of use of vascular active drugs, the anesthesia operation time, the operation time, and the adverse reactions and complications during perianesthesia period. Results There were no statistical difference in blood pressure and heart rate among the three groups. Anesthesia operation timein group A(24.24 ± 7.27 min) was significantly longer than that of group B(8.20 ± 3.48 min) and group C(8.76 ± 3.69 min)(P < 0.01), however, there was no statistical difference between group B and C. The three groups had no significant difference in operation time. Conclusion Compared with continuous epidural anesthesia, fast track general anesthesia may speed up the turnover rate of operatingtable for urological endoscopic surgery with few adverse reaction and complications.更多还原