Zhang Hong-Wei, Chen Ya-Jin, Cao Ming-Hui, Ji Feng-Tao
Department of Hepatobiliary Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
Am Surg. 2012 Jan;78(1):107-10.
There are limited data about laparoscopic cholecystectomy (LC) under epidural anesthesia. This retrospective comparative study aimed to evaluate on the feasibility and advantages of LC under epidural anesthesia. In this retrospective comparative study, 100 patients (46 men and 54 women) with symptomatic cholelithiasis undergoing laparoscopic cholecystectomy using epidural anesthesia (EA) were compared with 100 patients undergoing laparoscopic cholecystectomy using general anesthesia (GA). Both groups were evaluated with regard to intraoperative mean arterial pressure, heart rate, operation time, duration of stay in the recovery room, and hospital cost. Laparoscopic operation was performed for 200 patients. Mean age of patients was 46.4 ± 6.9 years and 45.3 ± 6.8 years in EA and GA, respectively. Forty-six and 50 per cent of subjects were male in EA and GA, respectively. The mean operation time was 24 minutes and 25.58 minutes for EA and GA, respectively (P = 0.652). The duration of stay in the recovery room was significantly shorter in EA than that in GA (19.56 ± 2.55 minutes vs 56.27 ± 6.85 minutes, respectively; P = 0.0001). In the EA group, 23 patients (23%) had severe shoulder pain during surgery. After receiving pethidine intravenously, all these patients could subsequently undergo surgery smoothly. There were no complications or mortality in either group. Most of the patients regarded EA as a comfortable procedure. The mean hospital cost for the EA group was only three-fourths that of the GA group. LC under EA is feasible and safe in selected patients.
关于硬膜外麻醉下腹腔镜胆囊切除术(LC)的数据有限。这项回顾性对照研究旨在评估硬膜外麻醉下LC的可行性和优势。在这项回顾性对照研究中,将100例接受硬膜外麻醉(EA)进行腹腔镜胆囊切除术的有症状胆结石患者(46例男性和54例女性)与100例接受全身麻醉(GA)进行腹腔镜胆囊切除术的患者进行比较。对两组患者的术中平均动脉压、心率、手术时间、恢复室停留时间和住院费用进行评估。对200例患者进行了腹腔镜手术。EA组和GA组患者的平均年龄分别为46.4±6.9岁和45.3±6.8岁。EA组和GA组分别有46%和50%的受试者为男性。EA组和GA组的平均手术时间分别为24分钟和25.58分钟(P = 0.652)。EA组在恢复室的停留时间明显短于GA组(分别为19.56±2.55分钟和56.27±6.85分钟;P = 0.0001)。在EA组中,23例患者(23%)在手术期间出现严重肩痛。静脉注射哌替啶后,所有这些患者随后都能顺利完成手术。两组均无并发症或死亡病例。大多数患者认为EA是一种舒适的手术方式。EA组的平均住院费用仅为GA组的四分之三。在选定的患者中,硬膜外麻醉下的LC是可行且安全的。