Sabate A, Peña M J, Vila C, Alemany O
Department d'Anestesia i Reanimació, Ciutat Sanitària de Bellvitge, Hospitalet del Llobregat, Barcelona.
An Med Interna. 1997 Jun;14(6):291-6.
Combined general and epidural anaesthesia in abdominal surgery has shown, both, protective and no effect on final outcome. The aim of this study was to evaluate combined epidural and general anesthesia.
One hundred and eighty four patients, diagnosed of neoplastic process, in whom an elective procedure of coloproctologic resection and reconstruction was scheduled during the period between January-1993 and December 1994, were studied. In thirty consecutive patients a combined general-epidural anaesthesia (EA) was performed. These patients were compared to thirty general anaesthesia patients (GA), selected randomly from the same period.
Both groups were comparable for demographic characteristics and for the type and duration of the surgical procedure. Red Blood Cells units transfused were 1.7 +/- 3 in the EA group and 1.4 +/- 1.9 in the GA group. After the operation, most of patients went to SICU. The length of the hospital stay was 13 +/- 6 days for GA group, while for EA group was .13 +/- 5. The hospital mortality for all operated patients (N = 184) was 1.1%, which were directly related to failure of surgical anastomosis. The need for mechanical ventilation and pulmonary complications were similar in both groups. When analyzing costs, EA group represented a value (pesetas) of 433,501 +/- 183,337 for GA group and 437,735 +/- 149,572 for EA group.
As shown, in the actual context, we conclude that the anaesthetic technique did not have any influence on outcome or on cost.
腹部手术中联合全身麻醉和硬膜外麻醉已显示出对最终结局既有保护作用又无影响。本研究的目的是评估联合硬膜外麻醉和全身麻醉。
研究了184例被诊断为肿瘤性疾病的患者，他们计划在1993年1月至1994年12月期间进行择期结直肠切除和重建手术。连续30例患者接受了全身 - 硬膜外联合麻醉（EA）。将这些患者与同期随机选择的30例全身麻醉患者（GA）进行比较。
两组在人口统计学特征以及手术类型和持续时间方面具有可比性。EA组输注的红细胞单位为1.7±3，GA组为1.4±1.9。术后，大多数患者进入外科重症监护病房（SICU）。GA组的住院时间为13±6天，而EA组为13±5天。所有手术患者（N = 184）的医院死亡率为1.1%，这与手术吻合失败直接相关。两组在机械通气需求和肺部并发症方面相似。在分析成本时，GA组的价值（比塞塔）为433,501±183,337，EA组为437,735±149,572。
如所示，在实际情况下，我们得出结论，麻醉技术对结局或成本没有任何影响。
