摘要
目的探讨无创正压通气复合腰-硬联合麻醉行妇科腹腔镜手术的安全性和可行性。方法30例在腰-硬联合麻醉下行妇科腹腔镜手术的患者(ASAⅠ-Ⅱ级),随机分为两组,每组15例,A组:鼻饲给氧,B组:无创正压通气(NPPV)。观麻记录麻醉前、后,气腹后10min、30min、1h,术毕15min各时点的HR、SpO2、MAP、RR,并采集动脉血,行血气分析。结果A组SpO2、RR、PH麻醉后与麻醉前及B组同时点比较下降明显(P<0.05)。A、B两组MAP、HR及B组SpO2、RR麻醉后各时点与术前比较无明显变化(P>0.05)。两组PaO2术中均较麻醉前明显增高(P<0.05),麻醉后B组与A组各时点比增加更为明显(P<0.05)。A组PaCO2麻醉后与麻醉前及B组同时点比较明显增高(P<0.05)。但各参数术毕15min均恢复至麻醉前水平。结论无创正压通气复合腰-硬联合麻醉行妇科腹腔镜手术,可避免术中因二氧化碳蓄积而发生高碳酸血症和酸中毒危险。
Objective To evaluate the safety and feasibility of non-invasive positive pressure ventilation (NPPV) in gynecological laparoscopic (GL) operation under combined spinal-epidural anesthesia. Methods Thirty patients, ASA Ⅰ- Ⅱ , undergoing GL operation under combined spinal-epidural anesthesia were randomly divided into two groups: transnasal oxygen supply in group A (n = 15) and NPPV in group B (n = 15). HR, SpO2, MAP, RR and the changes of arterial blood gas were recorded before anesthesia, after anesthesia, at 10 min, 30 min, 1 h after pneumoperitoneum and 15 min after peritoneal deflation. Results MAP, HR in group A and B and SpO2, RR, pH, PaCO2 in group B were variable slightly during the operation. SpO2, RR, pH decreased significantly after anesthesia in group A in comparison with those before anesthesia or at the same points during the operation in group B (P〈0. 05). PaO2 increased obviously during the operation in two groups, but more significantly in group B at each time point (P〈0. 05). PaCO2 in group A increased significantly after anesthesia as compared to those before anesthesia and at the same point during the operation in group B (P〈0. 05). But all parameters came to the preanesthesia level in 15 min after peritoneal deflation. Conclusion NPPV in GL operation under combined spinal-epidurat anesthesia is safe and feasible, which can avoid hypercapnia and slight acidosis during operation.
出处
《华南国防医学杂志》
CAS
2007年第5期11-13,共3页
Military Medical Journal of South China
基金
广西卫生医疗科研课题(Z2005171)
关键词
无创正压通气
联合麻醉
腹腔镜
Non-invasive positive pressure ventilation
Combined anesthesia
Laparoscope