硬膜外阻滞与全麻在腹腔镜胆囊切除术中的效果比较

摘要

Objective To compare the efficacy of epidural blockade with that of general anesthesia in laparoscopic cholecystectomy. Methods 50 ASA Ⅰ-Ⅱ patients scheduled for elective laparoscopic cholecystectomy were randomly assigned to receive general anesthesia ( 25 patients, control group ), or epidural blockade( 25 patients, study group ). Systolic blood pressure( SBP ), diastolic pressure( DBP), heart rate ( HR ), and SpO2 were observed in the two groups before and after the formation of artificial pneumoperitoneum. The changes in PETCO2 were observed in the study group. Results 15 minutes after the formation of pneumoperitoneum, SBP, DBP, and HR were declined in the control group, while they were slightly elevated in the study group there was a statistical difference between the two group ( P < 0. 01 ). PETCO2 was notably increased in the study group. Conclusions General anesthesia is superior to epidural blockade in laparoscopic cholecystectomy.%目的 比较硬膜外阻滞与全麻在腹腔镜胆囊切除术中的效果.方法 选择ASAI～Ⅱ级择期行腹腔镜胆囊切除术的患者50例,随机分为对照组和观察组,每组各25例;观察组采用全身麻醉方法,对照组采用硬膜外阻滞.观察并记录两组气腹前、后的收缩压(SBP)、舒张压(DBP)、心率(HR)、脉搏氧饱和度(SPO2)以及观察呼气末CO2浓度(PETCO2)的变化.结果 对照组气腹后15 min,SBP、DBP、HR均有所下降,观察组则有轻微的上升,两组比较差异有统计学意义(P<0.01);观察组PETCO2明显上升.结论 气管内插管全麻用于腹腔镜胆囊切除术优于硬膜外阻滞.