Clinical value of general anesthesia combined with epidural anesthesia in laparoscopic radical resection of rectal cancer

Abstract

Objective To explore the application of general anesthesia combined with epidural anesthesia in laparoscopic radical resection of rectal cancer. Methods From February 2015 to July 2016, 95 rectal cancer patients undergoing laparoscopic radical resection in the Fifth People's Hospital of Datong were randomly divided into general anesthesia(GA) group(48 cases) and GA combined with epidural anesthesia(CEGA) group(47 cases) according to the digital table.The effect of anesthesia, hemodynamic index, recovery time, extubation time, general anesthesia dosage, adverse reaction were assessed. Results In the CEGA group, 89.36% reached the level Ⅰ~Ⅱ anesthesia, GA group was 72.92%, the difference between the two groups was statistically significant (U=5.034, P<0.05). The anesthesia dosage of the GA group was higher than that of the CEGA group[(780.26±152.01)mg vs.(499.31±153.01)mg, the difference between the two groups was statistically significant(t=4.561, P<0.05). The recovery time, operation time in the CEGA group were (10.26±2.81)min, (139.26±34.16)min, respectively, which in the group GA were (23.46±3.64)min, (109.23±35.03)min, respectively, the difference between the two groups was statistically significant (t=6.235, 9.490, all P<0.05). The incidence rate of adverse reaction of the CEGA group was 10.64%, which of the GA group was 27.08%, the difference between the two groups was statistically significant (χ2=10.342, P<0.05). At pneumoperitoneum and extubation, HR, MVP in the GA group were (105.26±15.07)times/min, (109.18±16.27)times/min, (13.26±2.65)kPa, (14.91±2.57)kPa, respectively, which were significantly higher than those in the CEGA group (t=6.575, 6.154, 5.842, 6.544, all P<0.05). The Steward awakening scores of each base point before and after extubation in the CEGA group were significantly higher than those in the GA group (t=6.354, 3.268, 3.869, 3.992, 3.564, 4.065, 4.031, 4.689, all P<0.05). Conclusion CEGA has good anesthetic effect, less dosage in general anesthesia, little influence on hemodynamics and easy to wake up.It is an ideal anesthesia method for laparoscopic radical resection of rectal cancer. Key words: Anesthesia, general; Anesthesia, epidural; Laparoscopy; Colorectal surgery