硬膜外麻醉下腹腔镜胆囊切除术：一项可行性研究。
Laparoscopic cholecystectomy under epidural anesthesia: a feasibility study.
作者信息
Hajong Ranendra, Khariong Peter Daniel S, Baruah Arup J, Anand Madhur, Khongwar Donkupar
机构信息
Department of Surgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.
出版信息
N Am J Med Sci. 2014 Nov;6(11):566-9. doi: 10.4103/1947-2714.145468.
BACKGROUND
Laparoscopic cholecystectomy (LC) is normally performed under general anesthesia. But of late this operation has been tried under regional anesthesia successfully without any added complications like epidural anesthesia.
AIMS
The aim of the study was to study the feasibility of performing LC under epidural anesthesia in normal patients so that the benefits could be extended to those high-risk patients having symptomatic gallstone disease and compromised cardio-pulmonary status where general anesthesia is contraindicated.
MATERIALS AND METHODS
In all, 20 patients with the American Society of Anesthesiologist's class I or II were enrolled in the study. The level of epidural block and satisfaction score, both for the patient and the surgeon, were noted in the study.
RESULTS
The LC was performed successfully under epidural anesthesia in all but two patients who had severe shoulder pain in spite of giving adequate analgesia and were converted to general anesthesia.
CONCLUSIONS
The LC can be performed safely under epidural anesthesia with understanding between patient and surgeon. However, careful assessment of complications in the patients should be done to make the procedure safer.
背景
腹腔镜胆囊切除术（LC）通常在全身麻醉下进行。但近来该手术已成功尝试在区域麻醉下进行，且未出现如硬膜外麻醉等额外并发症。
目的
本研究旨在探讨正常患者在硬膜外麻醉下进行LC的可行性，以便将其益处扩展至有症状胆结石疾病且心肺功能受损、禁忌全身麻醉的高危患者。
材料与方法
总共纳入20例美国麻醉医师协会分级为I或II级的患者。研究中记录硬膜外阻滞平面以及患者和外科医生的满意度评分。
结果
除两名患者外，所有患者均在硬膜外麻醉下成功完成LC，这两名患者尽管给予了充分镇痛仍出现严重肩部疼痛，随后转为全身麻醉。
结论
在患者和外科医生相互理解的情况下，LC可在硬膜外麻醉下安全进行。然而，应仔细评估患者的并发症，以使手术更安全。
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