Steinhoff H, Maar K, Halbig W, Siepmann H
Anasth Intensivther Notfallmed. 1980 Oct;15(5):387-91.
In a retrospective study of retroperitoneal lymph-adenectomy it was investigated whether the choice of anaesthesia and the difference in management of postoperative pain alleviation does influence the postoperative course. In comparing group I (n = 43), patients anaesthesized with volatile anaesthetics (enflurance, halothane) while postoperative pain relief was obtained by meperidine and pentazocine and group II (n = 28), anaesthesized with a high epidural block combined with light narcosis with oxygen, nitrous oxygen and diazepam, while postoperative pain relief was obtained by a continuous epidural block we found: In comparison to group I the stay in group II was shorter. There was one patient in group II with intestinal obstruction, but in group I were seven patients with clinical signs of intestinal obstruction. In group I the evaluation of the bowel took place after 36 hours, in group II after 20 hours. One patient in group I died after three days because of pneumonia combined with intestinal obstruction. The consumption of meperidine and pentazocine in comparison group II to group I were diminished to round about 85%. We think that there is a direct relation between anaesthesia, postoperative pain alleviation and the postoperative course. High epidural anaesthesia in combination with light anaesthesia and postoperative epidural analgesia seems to be better than inhalational anaesthesia for the patients we explored in our retrospective study.
在一项关于腹膜后淋巴结清扫术的回顾性研究中，调查了麻醉方式的选择以及术后疼痛缓解管理的差异是否会影响术后病程。比较第一组（n = 43），患者采用挥发性麻醉剂（安氟醚、氟烷）麻醉，术后通过哌替啶和喷他佐辛缓解疼痛；第二组（n = 28），采用高位硬膜外阻滞联合轻度麻醉，吸入氧气、氧化亚氮并使用地西泮，术后通过持续硬膜外阻滞缓解疼痛。我们发现：与第一组相比，第二组的住院时间更短。第二组有1例患者发生肠梗阻，而第一组有7例患者出现肠梗阻的临床体征。第一组在术后36小时评估肠道功能，第二组在术后20小时评估。第一组有1例患者在术后三天因肺炎合并肠梗阻死亡。与第一组相比，第二组哌替啶和喷他佐辛的消耗量减少了约85%。我们认为麻醉、术后疼痛缓解与术后病程之间存在直接关系。在我们的回顾性研究中，对于所研究的患者，高位硬膜外麻醉联合轻度麻醉及术后硬膜外镇痛似乎优于吸入麻醉。
