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| Effects of epidural block anesthesia combined with general anesthesia during laparoscopic surgery for gynecological tumors of patients on their hemodynamics, stress response, and postoperative recovery |
| Panzhihua Central Hospital, Panzhihua, Sichuan Province, 617067 |
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Abstract To explore the effects of epidural block anesthesia combined with general anesthesia during laparoscopic surgery for gynecological tumors of patients on their hemodynamics, awakening time, and adverse reactions. Methods: The clinical data of 96 patients undergoing laparoscopic surgery of gynecological tumors between January 2020 and January 2021 were analyzed retrospectively. According to different anesthesia methods, these patients were divided into group A (48 patients with epidural block anesthesia combined with general anesthesia) and group B (48 patients with general anesthesia). The surgical status, the hemodynamics indexes, such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation (SpO2), the coagulation function indexes, such as partial activated thromboplastin time (APTT) and prothrombin time (PT), the blood glucose level, the cognitive status before surgery and in 1 d after surgery, such as Mini-Mental State Examination (MMSE) and Trial Making Test (TMT), of the patients at before anesthesia (T0), during intubation (T1), 30min after pneumoperitoneum cessation (T2), and 24h after surgery (T3) were compared between the two groups. The occurrence of adverse reactions of the patients was compared between the two groups. Results: There were no significant differences in the operation time and the pneumoperitoneum time of the patients between the two groups (P＞0.05). The recovery time (16.7±5.7min) of the patients in group A was significantly lower than that (26.1±8.8min) of the patients in group B (P＜0.05). The HR value and SpO2 level of the patients in both groups, the values of SBP and DBP of the patients in group A at T1 and T2 had no significantly different from those of the patients at T0. The values of SBP and DBP of the patients in group B at T2 had no significantly different from those at T0 (all P＞0.05). The values of SBP and DBP of the patients in group B at T1 were significantly higher than those of the patients at T0 (P＜0.05). There were no significant differences in the values of HR, SpO2, SBP, and DBP of the patients at T0, T1, and T2 between the two groups (all P＞0.05), the values of SBP and DBP of the patients in group A were significantly lower than those of the patients in group B (P＜0.05). There were no significant differences in the PT level and APTT level of the patients at T0, T1, T2, and T3 between the two groups (P＞0.05). The level of APTT of the patients in group A at T2 was significantly higher than that of the patients in group B (P＜0.05). There was no significant difference in the blood glucose level of the patients at T0 between the two groups (P＞ 0.05). The blood glucose level of the patients in group A at T2 or T3 was significantly lower than that of the patients in group B (P＜0.05). 1 day after operation, the MMSE score (26.47±1.15 points) of the patients in group A was significantly higher than that (25.25±1.29 points) of the patients in group B, and the TMT (41.69±5.01s) of the patients in group A was significantly lower than that (45.11±4.94s) of the patients in group B (all P＜0.05). There was no significant difference in the incidence of adverse reactions of the patients between the two groups (P＞0.05). Conclusion: Epidural block anesthesia combined with general anesthesia during laparoscopic surgery for gynecological tumors of the patients has more stable hemodynamics, shorter awakening time, with less impact on their coagulation function, stress response, and cognitive function.
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