全麻复合硬膜外麻醉与单纯全麻用于腹腔镜下腹股沟疝修补术的比较

Abstract

目的：比较全麻复合硬膜外麻醉与单纯全麻对腹腔镜下腹股沟疝修补术的临床效应的影响。方法：择期进行腹腔镜完全腹膜外疝修补术患者60例，随机分为硬膜外麻醉 + 全麻组(I组)和单纯全麻组(II组)，记录两组患者麻醉前5 min (T1)、麻醉后30 min (T2)、手术结束(T3)时血流动力学变化和动脉血pH值、血糖值，术中丙泊酚与瑞芬太尼用量、停药至苏醒时间、苏醒至拔管时间、术后躁动发生率及术后患者和术者满意度情况。结果：I组瑞芬太尼用量少于II组，I组拔管时间短于II组，差异有统计学意义(P < 0.01)，I组患者术后满意度高于II组(P < 0.05)，差异有统计学意义。结论：全麻复合硬膜外麻醉用于腹腔镜下腹股沟疝修补术可以减少术中瑞芬太尼用量，缩短拔管时间并能提高术后患者镇痛满意度。 Objective: To observe the effect of combined general-epidural anesthesia and general anesthesia in patients undergoing laparoscopic inguinal hernia repair operation. Methods: Sixty patients un-dergoing totally extraperitoneal prosthesis (TEP) operation were randomly allocated into combined general-epidural anesthesia group (group I) and general anesthesia group (group II). At the time of 5 minutes before anesthesia (T1), 30 minutes after anesthesia (T2) and operation ending (T3), hemodynamic parameters, arterial blood pH and glucose were recorded. We also record the dose use of propofol and remifentanil, the time from ending of narcotic to recovery, time from recovery to extubation, post-operative confusion rates and satisfaction rates both of patients and operators. Results: Compared with group II, usage of remifentanil and extubation time were significantly decreased in group I (P < 0.01). Patients in group I had a better post-operative satisfaction than that of group II (P < 0.05). Conclusion: Combined general-epidural anesthesia can decrease the usage of remifentanil, shorten the extubation time and provide a better satisfaction of post-operative pain management in laparoscopic inguinal hernia repair operation.