Effect of different anesthesia methods on irculation and stress reaction in patients underwent gynecological laparoscopic surgery

摘要

Objective:To observe the effect of different anesthesia methods on the circulation and stress reaction in patients underwent gynecological laparoscopic surgery.Methods:A total of 120 gynecological patients who were admitted in our hospital from December, 2014 to October, 2015 for laparoscopic surgery were included in the study and randomized into group I, II, and III. The patients in the three groups were performed with the operation under CSEA, general anesthesia, and combined general-epidural-anesthesia, respectively. Non-invasive BP, HR, and ECG before anesthesia (T0), before pneumoperitoneum (T1), 10 min after pneumoperitoneum (T2), 20 min after pneumoperitoneum (T3), and 10 min after operation (T4) in the three groups were monitored. Blood was collected at T0, T3, and T4, respectively for blood gas examination. E, NE, and COS concentrations were detected.Results:HR at T2 in group I was significantly slow down (P<0.05), SBP and DBP were significantly reduced (P<0.05), and were significantly lower than those in group II and III (P<0.05), while the difference of SPO2 at each timing point was not significant (P>0.05). HR, SBP, DBP, and MAP at T2 and T3 in group II were significantly elevated (P<0.05). The difference of HR, SBP, DBP, and SPO2 at each timing point in group III was not significant (P>0.05). N, NE, and COS concentrations at T3 in group II were significantly elevated (P<0.05), and the difference of N, NE, and COS concentrations at T1 between group I and III was not significant (P>0.05). pH, PaCO2, and HCO3- at T3 and T4 in group I were significantly higher than those at T0 (P<0.05), PaCO2, and HCO3- at T3 in group I were significantly higher than those in group II and III (P<0.05), PaCO2 at T4 was significantly higher than that in group II and III (P<0.05). The difference of pH, PaCO2, and HCO3- at T0, T3, and T4 between group II and III was not significantly different (P>0.05).Conclusions:During the gynecological laparoscopic surgery, the three anesthesia methods can achieve a satisfactory anesthetic effect, but the combined general-epidural-anesthesia has a small effect on the blood pressure, respiration, and circulation, can alleviate the stress reaction, and maintain a favorable blood gas state; therefore, it should be preferred.