The Respective Analysis Of Two Methods Of Anesthesia In Ectopic Pregnancy Operations

Objective:To observe and analyze the factors which can predict the probability of blood pressure disturbances in ectopic pregnancy operations and compare the differences of the cost-effects as well as effects on circulation using two different anesthesia techniques. Methods:One hundred and ninety-two patients in First Affiliation Hospital of Xinjiang Medical University were enrolled in the retrospective study. In a preliminary study ,a logistic model was developed to evaluate predictors of intraoperative blood disturbances. Next, Seventy-two patients undergone ectopic pregnancy operations were studied. Thirty-six patients in general anesthesia group performed with midazolam 0.15-0.2mg/kg,fentanyl 0.1-0.2 mg,vecuronium 0.1 mg/kg for induction followed by propofol infusion at the rate of 4-6 mg/kg·h and intermittent fentanyl 0.1-0.2 mg and vecuronium 0.05 mg/kg injection for maintenance. Thirty-six patients in epidural anesthesia group received 2% lidocaine 4-5 ml to inspect the effect of anesthesia then were injected with 1% ropivacine 8-10 ml and added with 4-5 ml after 2.5 hours. Hemodynamic disturbances,anesthesia times and direct costs in the two groups were observed and analyzed. Finally, a strategy was developed to help anesthetists to select reasonable method. Results: Preoperative factors, such as shock index, mean arterial pressure and different anesthesia method can predict the incidence of blood pressure disturbance in in ectopic pregnancy operations. Compared with general anesthesia group in which five patients (13.9%) suffered with blood pressure disturbances, the frequency of blood pressure disturbance in epidural anesthesia was 41.7% (15 cases). The differences were significant(P=0.009).The anesthesia costs,drugs costs,total costs in general anesthesia group and epidural anesthesia group were 897.6±67.1,414.4±122.7,1312.1±160.3 and 438.3±46.5,269.7±91.4,708.0±112.0 yuan(P<0.001), the differences were statistically significant. The median and mode of anesthesia time in general anesthesia group and epidural anesthesia group were 2.5h,2h and 2h,2h.there is no significant between them. Conclusions:Shock index, mean arterial pressure and different anesthesia method can predict the incidence of blood pressure disturbance in in ectopic pregnancy operations. Hemodynamic status may be more stable, effects of analgesia may be better in general anesthesia group compared with epidural anesthesia group. Total costs in general anesthesia group was higher than epidural anesthesia group.