The influence of general combined epidural anesthesia on stress reaction in patients with laparoscopic gallbladder resection

Abstract

Objective To compare the effects of general anesthesia combined with epidural space block anesthesia and pure general anesthesia on intraoperative circulation and stress reaction in patients with laparoscopic cholecystectomy. Methods 60 patients undergoing elective surgery of laparoscopic cholecystectomy were randomly divided into general anesthesia compound epidural group (group A) and general anesthesia group (group B), 30 cases in each group.The MAP, HR, C-reactive protein (CRP), epinephrine (E) and norepinephrine (NE) concentrations in the two groups at 5 min before anesthesia (T0), 15min after the pneumoperitoneum (T1), and stop 10 min after pneumoperitoneum (T2) were compared. Results T1 MAP and HR in group B[ (95.4±4.6) mmHg, (90.5±12.2)times/min]were significantly higher than those in group A[(87.1±6.0)mmHg, (83.2±13.5)times/min] (t1=7.81, t2=6.98, all P<0.05). In group B, the E and NE levels at T1, T2 and CRP level at T2[(242.1±40.5)ng/L, (271.5±31.5)ng/L, (238.0±41.8)ng/L, (265.1±40.6)ng/L, (39.3±3.9)mg/L] were significantly higher than those of group A[(195.7±28.0)ng/L, (236.9±20.3)ng/L, (191.3±31.8)ng/L, (239.2±34.2)ng/L, (26.3±3.8)mg/L] (t1=10.02, t2=8.06, t3=9.42, t4=8.69, t5=9.48, all P<0.05). The sober and postoperative extubation time of group A[(7.2±0.8)min, (11.2±7.3)min] were significantly shorter than group B[(16.4±0.8)min, (18.8±0.4)min] (t1=9.81, t2=9.60, all P<0.05). Conclusion Compared with the pure general anesthesia, general anesthesia compound epidural block can inhibit the postoperative stress reaction. Key words: Cholecystectomy, laparoscopic; Anesthesia, epidural block; Anesthesia, general; Acute-phase reaction