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胸段硬膜外麻醉与全身麻醉对腹腔镜胆囊切除术患者血流动力学变化及其并发症影响的比较

Comparison of the Effects of Thoracic Epidural Anesthesia with General Anesthesia on Hemodynamic Changes and its Complications in Patients Undergoing Laparoscopic Cholecystectomy.

作者信息

Majedi Mohammad Azad, Sarlak Shahab, Sadeghi Yasaman, Ahsan Behzad

机构信息

Department of Anesthesiology, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Department of Medicine, General Physician, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2019 Jan 31;8:7. doi: 10.4103/abr.abr_193_18. eCollection 2019.

Abstract

BACKGROUND

Epidural anesthesia (EA) today has been used extensively in surgical procedures and the management of pain associated with midwifery and chronic pain. This type of anesthesia can be done in different technical, physiological, and pharmacological ways. The aim of this study was to compare the effects of thoracic EA with general anesthesia (GA) on hemodynamic changes and its complications in patients underwent laparoscopic colonoscopy.

MATERIALS AND METHODS

This clinical trial study was conducted on 80 patients undergoing laparoscopic cholecystectomy with EA or GA based on inclusion and exclusion criteria. The patients were randomly divided into two groups of 40 and changes in blood pressure, systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), and arterial blood oxygen saturation were measured. The incidence of nausea, vomiting, chills, and itching in the two groups was recorded. The analysis was performed descriptively and also using -test and Chi-square tests.

RESULTS

The results showed that the mean of SBP and DBP, HR, and arterial blood oxygen saturation and the incidence of nausea and vomiting was statistically significant ( < 0.05) between the two groups at 4, 6, and 12 h after anesthesia and it was higher in a group of GA. There was no significant difference in shivering and itching between the two groups ( > 0.05).

CONCLUSION

The results of this study indicated that thoracic EA in patients with laparoscopic cholecystectomy has significant effects on factors such as SBP and DBP and arterial blood oxygen saturation. Furthermore, EA has fewer complications than GA, and it is the preferable approach.

摘要

背景

如今,硬膜外麻醉(EA)已广泛应用于外科手术以及助产相关疼痛和慢性疼痛的管理。这种麻醉方式可以通过不同的技术、生理和药理学方法来实施。本研究的目的是比较胸段硬膜外麻醉与全身麻醉(GA)对接受腹腔镜结肠镜检查患者血流动力学变化及其并发症的影响。

材料与方法

本临床试验研究针对80例根据纳入和排除标准接受EA或GA的腹腔镜胆囊切除术患者进行。将患者随机分为两组,每组40例,测量血压、收缩压(SBP)、舒张压(DBP)、心率(HR)和动脉血氧饱和度的变化。记录两组中恶心、呕吐、寒战和瘙痒的发生率。分析采用描述性分析以及t检验和卡方检验。

结果

结果显示,麻醉后4、6和12小时,两组之间的SBP、DBP、HR平均值以及动脉血氧饱和度和恶心呕吐发生率具有统计学意义(P<0.05),且GA组更高。两组之间的寒战和瘙痒无显著差异(P>0.05)。

结论

本研究结果表明,腹腔镜胆囊切除术患者采用胸段硬膜外麻醉对SBP、DBP和动脉血氧饱和度等因素有显著影响。此外,硬膜外麻醉的并发症比全身麻醉少,是更可取的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b138/6385560/5571091ec2ba/ABR-8-7-g001.jpg

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