Objective: To explore the anesthesia methods and security of laparoscopic gynecologic operation. Methods: 200 patients of ASA I - II undergoing laparoscopic gynecologic operation were randomly divided into continual epidural anesthesia (CEA) group (group I ,n=100) and combined spinal epidural anesthesia (CSEA) group (group Ⅱ , n=100). Both groups were applied with intravenous anesthesia. The changes of the BP, HR, RR, SpO2 were monitored through the operation. The anesthetic effects, muscle relaxing condition, pulling reaction and postoperative complications were observed. Results: Both groups achieved good anesthetic effects, muscle relaxed well, and no anesthetic complications were found. BP, HR, RR, SpO2 monitored fluctuated greater after insufflation in group I compared with that before operation and that after anesthesia, there were significant differences (P<0.01). In group Ⅱ, compared with group I the fluctuation was smaller (P< 0.01) and compared with before operation and after anesthesia there was no difference (P>0.05). Conclusion: CEA and CSEA with Propofol intravenous anesthesia applied during laparoscopic gynecologic operation, the patients can keep spon -taneous breathing, recover rapidly and with few complications. CSEA blocks motor nerves more completely, reduces sympa -thetic nerves tension and patients' BP, HR, RR, SpO2fluctuate little. CSEA is an ideal anesthesia method.%目的:探讨腹腔镜下妇科手术的麻醉方法及安全性.方法:将200例ASAⅠ～Ⅱ级实施腹腔镜妇科手术患者随机分成两组,Ⅰ组为连续硬膜外麻醉(100例),Ⅱ组为腰-硬联合麻醉(100例),两组均加静脉麻醉,全程监测BP、HR、RR、SpO2等指标,观察其变化情况、麻醉效果、肌松程度及牵拉反应和术后并发症.结果:两组麻醉效果均为优良,肌松良好,无麻醉并发症,BP、HR、RR、SpO2气腹前后监测,硬膜外麻醉波动幅度较大,气腹后与术前、麻醉后相比,差异有高度统计学意义(P＜0.01),腰-硬联合麻醉波幅小,与Ⅰ组相比,差异有高度统计学意义(P＜0.01);气腹后与术前、麻醉后相比,差异无统计学意义(P＞0.05).结论:腹腔镜下妇科手术采用连续硬膜外麻醉或腰-硬联合麻醉配合异丙酚静脉麻醉,保持自主呼吸,并发症少,苏醒快,且腰-硬联合麻醉运动神经阻滞更完全,降低了交感神经张力,血压、心率、呼吸、SpO2波动小,是一种较为理想的麻醉方法.
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