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首页> 外文期刊>Journal of laparoendoscopic and advanced surgical techniques, Part A >Effects of Epidural-and-General Anesthesia Combined Versus General Anesthesia Alone on Femoral Venous Flow During Laparoscopic Cholecystectomy
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Effects of Epidural-and-General Anesthesia Combined Versus General Anesthesia Alone on Femoral Venous Flow During Laparoscopic Cholecystectomy

机译：硬膜外麻醉与全身麻醉联合全身麻醉对腹腔镜胆囊切除术中股静脉血流的影响

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Background and Objective: The pneumoperitoneum has been shown to decrease femoral blood flow, resulting in venous stasis. We analyzed the effects of the pneumoperitoneum and epidural analgesia on femoral vein diameter and the peak flow rate of femoral vein during laparoscopic cholecystectomy.Patients and Methods: Forty patients were randomly allocated to receive either combined epidural analgesia (EA) and general anesthesia (GA) (group EA/GA) or GA alone (group GA). Laparoscopic cholecystectomy was the standard operation for the selected patients. Then, 10 mL of 1% lidocaine in group EA/GA or physiologic serum in group GA was injected via epidural catheter. Peak flow rates (PFRs) of femoral vein cross-sectional areas (CSAs) were measured from the right femoral vein at three different times: after induction of anesthesia, during the pneumoperitoneum, and after abdominal deflation, but prior to reversal of anesthesia. Results: The two groups were similar in age, sex, body mass index, and duration of operation. The CSA slightly increased after the induction of anesthesia, compared with the previous measurements, although there was no statistical significance between them for both groups (P > 0.05). The PFR decreased, whereas the CSA increased during the pneumoperitoneum in each group. The PFR values after basal measurements were significantly higher in the EA/GA than in the GA group (P < 0.05). Group EA/GA had significantly lower heart-rate and blood-pressure levels during surgery than those in group GA (P < 0.05).Conclusions: Abdominal insufflation during laparoscopic cholecystectomy results in dilation and decreased flow in the common femoral vein. Epidural analgesia added to the GA partially compensated for the reduction in femoral PFR.
机译：背景与目的：气腹可以减少股动脉血流，导致静脉淤滞。我们分析了气腹和硬膜外镇痛对腹腔镜胆囊切除术中股静脉直径和股静脉峰值流速的影响。患者和方法：40名患者被随机分配接受硬膜外联合镇痛（EA）和全身麻醉（GA） （EA / GA组）或单独的GA（GA组）。腹腔镜胆囊切除术是所选患者的标准手术。然后，通过硬膜外导管注射EA / GA组的10 mL 1％利多卡因或GA组的生理血清。在三个不同的时间，分别从右股静脉测量股静脉横截面积（CSA）的峰值流速（PFR）：麻醉诱导后，气腹期间，腹腔放气后，但在麻醉反转之前。结果：两组在年龄，性别，体重指数和手术时间方面相似。与之前的测量结果相比，麻醉诱导后的CSA略有增加，尽管两组之间均无统计学意义（P> 0.05）。每组气腹期间PFR均下降，而CSA升高。 EA / GA基础测量后的PFR值显着高于GA组（P <0.05）。 EA / GA组手术期间的心率和血压水平明显低于GA组（P <0.05）。结论：腹腔镜胆囊切除术中的腹部吹入会导致股总静脉扩张和血流减少。硬膜外麻醉增加到GA部分补偿股骨PFR的减少。

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