全身麻醉联合硬膜外麻醉对腹腔镜直肠癌切除术患者血流动力学及临床效果分析

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Abstract Objective To explore the influence of hemodynamics and clinical effect of general anesthesia combined with epidural anesthesia on patients with laparoscopic rectal cancer resection. Methods From April 2016 to May 2019, 145 patients undergoing laparoscopic rectal cancer resection in Fuxin General Hospital of Liaoning Health Industry Group were selected and divided into combined group (75 cases, general anesthesia combined with epidural anesthesia) and single group (70 cases, general anesthesia). The extubation time, complete recovery time, hemodynamic indexes, visual analogue scale (VAS), alertness/sedation score (OAA/S) and complications were compared between two groups. Results The overall analysis showed that there were significant differences in ECG monitoring related indicators between two groups, time point comparison and interaction (P < 0.05). Further pairwise comparison, intra group comparison: one hours after pneumoperitoneum establishment, heart rate (HR) was faster than that before anesthesia, and mean arterial pressure (MAP), end expiratory CO2 partial pressure (PETCO2) and airway pressure (Paw) were higher than those before anesthesia in two groups (P < 0.05). One hour after operation, HR was faster than that before anesthesia, MAP and Paw were higher than those before anesthesia in two groups (P < 0.05). Comparison between two groups: one hours after pneumoperitoneum establishment, HR of combined group was slower than that of single group, MAP, PETCO2 and Paw of combined group were lower than those of single group (P < 0.05). One hour after operation, HR of combined group was slower than that of single group, MAP and Paw of combined group were lower than those of single group (P < 0.05). The extubation time and complete recovery time of combined group were shorter than those of single group, VAS of combined group was lower than that of single group, OAA/S of combined group was higher than that of single group, the differences were statistically significant (P < 0.05). The incidence of postoperative complications in combined group was lower than that in single group (P < 0.05). Conclusion General anesthesia combined with epidural anesthesia can stabilize the hemodynamic indexes during and after operation, shorten the time of extubation, relieve the pain after recovery, have good sedative effect and do not increase the postoperative complications. It is an effective anesthesia method for laparoscopic rectal cancer operation.

Key words： General anesthesia Epidural anesthesia Laparoscopic rectal cancer resection Hemodynamics

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BAO Yu. Analysis of hemodynamics and clinical effect of general anesthesia combined with epidural anesthesia on patients with laparoscopic rectal cancer resection[J]. 中国医药导报, 2021, 18(1): 123-126.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2021/V18/I1/123

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