Nakashima H, Ueo H, Takeuchi H, Arinaga S, Shibuta K, Tsuji H, Furuta T, Akiyoshi T
Department of Surgery, Kyushu University, Beppu, Japan.
Int Surg. 1995 Apr-Jun;80(2):125-7.
To evaluate the efficacy of a single application of epidural anesthesia without endotracheal intubation for pancreaticoduodenectomy (PD), the data on 30 patients who underwent PD were analyzed for their operative morbidity and mortality. These patients were classified into two groups according to the type of anesthesia performed: 15 received epidural anesthesia alone (Group I) and 15, general anesthesia under endotracheal intubation (Group II). The clinical characteristics of the patients in both groups were comparable at the time of operation, except that Group I included a significantly larger proportion of elderly patients than Group II (p < 0.05). Postoperative pulmonary complications (PPCs) occurred in 5 (33.3%) of the Group II patients, especially in elderly patients who underwent lengthy operations, whereas no such complications occurred in the Group I patients (p < 0.05), even in elderly patients with a long operating time. The curability of the malignant tumors and the incidences of other complications were not significantly different between the two groups. These findings suggest that a single application of epidural anesthesia is effective in preventing PPCs when performing a time-consuming PD, especially in elderly patients.
为评估单次硬膜外麻醉（不进行气管插管）用于胰十二指肠切除术（PD）的疗效，分析了30例行PD患者的手术发病率和死亡率数据。根据麻醉方式将这些患者分为两组：15例仅接受硬膜外麻醉（I组），15例接受气管插管全身麻醉（II组）。两组患者的临床特征在手术时具有可比性，但I组老年患者的比例明显高于II组（p<0.05）。II组5例（33.3%）患者发生术后肺部并发症（PPCs），尤其是接受长时间手术的老年患者，而I组患者未发生此类并发症（p<0.05），即使是手术时间长的老年患者。两组之间恶性肿瘤的治愈率和其他并发症的发生率无显著差异。这些发现表明，在进行耗时的PD手术时，单次硬膜外麻醉对预防PPCs有效，尤其是在老年患者中。
