Vofsi Oded, Barak Michal, Moscovici Roland, Bustan Moshe, Katz Yeshayahu
Department of Anesthesiology, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Med Sci Monit. 2004 Apr;10(4):CR152-5.
Conventional laparoscopy is aided by CO2 insufflation, which may impair the cardiorespiratory system and have life-threatening implications. This procedure is conducted under general anesthesia (GA). Gasless laparoscopy supposedly eliminates most of those disadvantages, but is technically more difficult to perform. In the present study, we compared cardiorespiratory parameters of conventional abdominal laparoscopy under GA to gasless laparoscopy under general or epidural anesthesia.
MATERIAL/METHODS: This is a prospective study. Twenty four healthy female patients undergoing gynecological laparoscopies lasting <90 min were randomly assigned to one of three groups: group 1, conventional laparoscopy under GA; group 2, gasless laparoscopy under GA; and group 3, gasless laparoscopy under epidural anesthesia. Cardiorespiratory parameters and length of operative, postanesthesia care unit (PACU), and hospitalization periods as well as analgesic requirements in the PACU and complications in the operative and postoperative periods were recorded.
No significant differences were detected between groups throughout the operative and postoperative periods, except for a rise in CO2 in group 1 and a lower analgesic requirement in the PACU in group 3.
General and regional anesthesia may be employed in gasless laparoscopy for gynecological surgery.
传统腹腔镜手术借助二氧化碳气腹,这可能损害心肺系统并带来危及生命的影响。该手术在全身麻醉(GA)下进行。无气腹腔镜手术据称可消除大部分此类缺点,但技术操作上更具难度。在本研究中,我们比较了全身麻醉下传统腹部腹腔镜手术与全身或硬膜外麻醉下无气腹腔镜手术的心肺参数。
材料/方法:这是一项前瞻性研究。24名接受持续时间<90分钟妇科腹腔镜手术的健康女性患者被随机分为三组之一:第1组,全身麻醉下传统腹腔镜手术;第2组,全身麻醉下无气腹腔镜手术;第3组,硬膜外麻醉下无气腹腔镜手术。记录心肺参数、手术时长、麻醉后监护病房(PACU)时长、住院时长以及PACU中的镇痛需求和手术及术后并发症情况。
在整个手术和术后期间,各小组之间未检测到显著差异,除了第1组二氧化碳升高以及第3组PACU镇痛需求较低。
无气腹腔镜手术用于妇科手术时可采用全身麻醉和区域麻醉。