| Objective To compare the hemodynamic changes of abdominal surgery patients using general anesthesia combined with thoracic epidural anesthesia (CGEA) or general anesthesia (GA). Methods Sixty patients undergoing elective abdominal surgery (including gastric cancer,gastric ulcer, giant spleen, bile duct stones, gallbladder stones, colon cancer) were randomly divided into experimental group (CGEA group n=30) and control group (GA group n=30). Both groups had no difference in sex, age, weight and induction drugs. CGEA group patients first underwent epidural catheter placement and injection of local anesthetic test dose, then all patients was induced with midazolam 0.05-0.1mg/kg, fentanyl 2-4μg/kg, vecuronium 0.1 mg/kg and etomidate 0.2-0.3 mg/kg and maintained with inhalation of isoflurane and constant intravenous infusion of propofol 2-4mg/(kg·h). The hemodynamic changes were recorded after entering into the operation room, before anesthesia induction, after intubation, at incision and surgical exploration, and after extubation. The consumed amount of anesthetics during the operation was also recorded. Results Anesthetic effect of both groups were satisfactory, CGEA group patients had more stable hemodynamics at tracheal intubation, skin incision, abdominal cavity exploration, and tracheal extubation compared with GA group (P<0.05). In CGEA group patients comsumed less anesthetics(P<0.05), recovered more quickly after operation and had no irritation, wound pain and other complications. Conclusion General anesthesia combined with thoracic epidural anesthesia can reduce the perioperative stress response and maintain hemodynamic stability, faster recovery and less complications. It can also reduce the consumed amount of intraoperative anesthetics, moreover epidural catheter can be used for ideal postoperative analgesia. Therefore general anesthesia combined with thoracic epidural anesthesia is suitable for abdominal surgery and should be used widely. |
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