摘要
目的 研究不同麻醉方法在高龄患者腹腔镜肠癌手术中的应用价值。方法 58例在本院行腹腔镜手术的高龄肠癌患者,用随机数字表法将其分为观察组和对照组,每组29例。对照组行全身麻醉(全麻),观察组行全麻复合硬膜外阻滞麻醉。比较两组患者麻醉优良率、呼吸恢复时间、睁眼时间、拔管时间、躁动发生情况以及气腹前、气腹时和气腹后的平均动脉压(MAP)、心率。结果 观察组的麻醉优良率96.55%高于对照组的79.31%,差异显著(P<0.05)。气腹前,两组患者MAP比较无明显差异(P>0.05);气腹时和气腹后,观察组MAP分别为(84.63±2.05)、(85.05±2.14)mm Hg(1 mm Hg=0.133 kPa)均低于对照组的(87.62±2.18)、(88.79±2.66)mm Hg,差异显著(P<0.05),且观察组血压更稳定。气腹前,两组患者心率比较,无明显差异(P>0.05);气腹时和气腹后,观察组患者心率分别为(83.53±2.05)、(78.07±2.11)次/min,均低于对照组的(90.12±2.17)、(85.46±2.48)次/min,差异显著(P<0.05),且观察组患者术中心率更为稳定。观察组患者的呼吸恢复时间(4.25±0.78)min、睁眼时间(8.87±1.45)min、拔管时间(14.66±1.38)min与对照组的(9.96±1.32)、(12.54±1.05)、(20.28±2.46)min相比较短,差异显著(P<0.05)。观察组的躁动发生率3.45%与对照组的20.69%相比较低,差异显著(P<0.05)。结论 将全麻复合硬膜外阻滞麻醉运用在高龄腹腔镜肠癌患者的手术中可获得较好的麻醉效果,既有利于患者术中血流动力学的稳定,又可以缩短患者术后清醒时间,降低躁动发生风险,优势突出,故具备临床借鉴与推广的价值。
Objective To study the practical value of different anesthesia methods for laparoscopic colon cancer surgery in elderly patients.Methods 58 elderly patients who underwent laparoscopic bowel cancer surgery were selected as the main subjects.They were divided into an observation group and a control group by random number table method,with 29 cases in each group.The control group underwent general anesthesia,and the observation group underwent general anesthesia combined with epidural block anesthesia.The excellent rate of anesthesia,respiratory recovery time,eye opening time,extubation time,agitation,mean arterial pressure(MAP)and heart rate before,during and after pneumoperitoneum were compared between two groups.Results The excellent rate of anesthesia in the observation group was 96.55%,which was higher than 79.31%in the control group,and the difference was significant(P<0.05).Before pneumoperitoneum,there was no significant difference in MAP between the two groups(P>0.05).During and after pneumoperitoneum,MAP of the observation group were(84.63±2.05)and(85.05±2.14)mm Hg(1 mm Hg=0.133 kPa),which were lower than(87.62±2.18)and(88.79±2.66)mm Hg of the control group,and the difference was significant(P<0.05);the blood pressure of the observation group was more stable.Before pneumoperitoneum,there was no significant difference in heart rate between the two groups(P>0.05).During and after pneumoperitoneum,the heart rate of the observation group were(83.53±2.05)and(78.07±2.11)beats/min,which were lower than(90.12±2.17)and(85.46±2.48)beats/min of the control group,and the difference was significant(P<0.05);and the intraoperative blood pressure of the observation group was more stable.In the observation group,the respiratory recovery time was(4.25±0.78)min,the eye opening time was(8.87±1.45)min,the extubation time was(14.66±1.38)min,which were shorter than(9.96±1.32),(12.54±1.05)and(20.28±2.46)min in the control group,and the difference was significant(P<0.05).The incidence of agitation in the observation group was 3.45%,which was lower than the control group's 20.69%,and the difference was significant(P<0.05).Conclusion General anesthesia combined with epidural anesthesia for elderly patients undergoing laparoscopic bowel cancer surgery is more conducive to improving the excellent rate of anesthesia,maintaining stable intraoperative hemodynamics,and shortening the postoperative wakefulness time and reducing the incidence of restlessness.Therefore,It is worthy of further promotion and application in clinical practice.
作者
庞欣杰
卢锦容
罗斌
黄天安
PANG Xin-jie;LU Jin-rong;LUO Bin(Department of Anesthesiology,Huaiji County People's Hospital,Zhaoqing 526400,China)
出处
《中国实用医药》
2024年第10期115-118,共4页
China Practical Medicine
关键词
全身麻醉
硬膜外阻滞麻醉
高龄患者
腹腔镜肠癌手术
麻醉效果
General anesthesia
Epidural block anesthesia
Elderly patients
Laparoscopic bowel cancer surgery
Anesthesia effect
