Anesteziol Reanimatol. 2011 Nov-Dec(6):34-8.
The aim of the study is to evaluate postoperative respiratory dysfunction in abdominal surgery based on level of invention and type anesthesia and postoperative pain management.
260 patients who underwent major abdominal surgery were assessed. 70 had operation in upper abdomen and were administered general anesthesia, 70 patients had same operation but had combined anesthesia inhalational and prolonged epidural on thoracic level. 120 patients were performed abdominal operation in lower abdomen 40 of them were administered with general anesthesia 40 patient had combined anesthesia inhalational with prolonged epidural and 40 had combined anesthesia inhalational and spinal anesthesia. We analyzed anesthesia and recovery period, postoperative pain management and sedation, the result of spirometria and arterial blood gasses.
both methods of regional anesthesia allowed to reduce amount of anesthetic agents and due to this shortened the time of anesthetic recovery. The results of spirometria were affected in all groups particularly in a group with abdominal surgery on upper region. Epidural anesthesia provided best result in postoperative pain management and improved result of spirometria in patients after abdominal surgery in upper and lower region. In addition patients after upper and lower abdominal surgery how received epidural analgesia in postoperative period had demonstrate better arterial blood gasses results than patients of all other groups. Method of spinal anesthesia did not demonstrate beneficial effects on the results of spirometria or arterial blood gasses. The rate of postoperative pneumonia was lower in groups with regional anesthesia.
extended-release epidural anesthesia was beneficial effects on postoperative respiratory dysfunction and reduces rate of pneumonia postoperatively.
本研究的目的是根据手术切口水平、麻醉类型和术后疼痛管理来评估腹部手术术后的呼吸功能障碍。
对260例行腹部大手术的患者进行评估。70例患者行上腹部手术并接受全身麻醉，70例患者行相同手术但采用吸入麻醉与胸段硬膜外延长麻醉联合使用。120例患者行下腹部手术，其中40例接受全身麻醉，40例接受吸入麻醉与硬膜外延长麻醉联合使用，40例接受吸入麻醉与脊髓麻醉联合使用。我们分析了麻醉及恢复期、术后疼痛管理和镇静情况、肺量计检查结果和动脉血气分析结果。
两种区域麻醉方法均能减少麻醉剂用量，从而缩短麻醉恢复时间。所有组的肺量计检查结果均受到影响，尤其是上腹部手术组。硬膜外麻醉在术后疼痛管理方面效果最佳，且改善了上腹部和下腹部手术后患者的肺量计检查结果。此外，上腹部和下腹部手术后接受硬膜外镇痛的患者在术后的动脉血气分析结果优于其他所有组。脊髓麻醉方法对肺量计检查结果或动脉血气分析结果未显示出有益影响。区域麻醉组的术后肺炎发生率较低。
延长释放硬膜外麻醉对术后呼吸功能障碍有有益影响，并降低术后肺炎发生率。
