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08 November 2016 : Clinical Research  

Effects of Combined General/Epidural Anesthesia on Hemodynamics, Respiratory Function, and Stress Hormone Levels in Patients with Ovarian Neoplasm Undergoing Laparoscopy

Qiang XuABCDEF, Hao ZhangBCDE, Yan-Mei ZhuCDE, Nian-Jun ShiDEF

DOI: 10.12659/MSM.897430

Med Sci Monit 2016; 22:4238-4246

Abstract

BACKGROUND: The aim of this study was to evaluate the influence of combined general/epidural anesthesia (GEA) on hemodynamics, respiratory function and stress hormone levels in patients with ovarian neoplasm undergoing laparoscopy.

MATERIAL AND METHODS: A total of 177 patients with ovarian neoplasm (screened by inclusion/exclusion criteria) receiving laparoscopy were divided into groups G (general anesthesia alone), L1.0 (GEA with 1.0% lidocaine), and L1.5 (GEA with 1.5% lidocaine). Hemodynamics, respiratory parameters and stress hormone levels in the 3 groups were recorded and analyzed.

RESULTS: Hemodynamic indexes and PaO2/PaCO2 in group L1.0 showed no differences at each time point (all P>0.05). At the end of anesthesia tracheal intubation (T1), 10 min after pneumoperitoneum (T2) and the end of anesthesia tracheal extubation (T3), there were significant differences in hemodynamic indexes, respiratory parameters, epinephrine (E), and noradrenalin (NE) of group G/L1.5, compared with before anesthesia induction (T0) (all P<0.05). Compared with group G, there were big differences in dosage of anesthetics (sufentanil, vecuronium, and propofol) and pharmaceutic adjuvants (ephedrine, atropine, and nitroglycerin), postoperative recovery time, extubation time, and incidence of agitation in group L1.0/L1.5 (all P<0.05).

CONCLUSIONS: GEA can improve the quality and efficiency in laparoscopy for ovarian neoplasm, with the advantages of reduced anesthetics dosage, satisfactory postoperative analgesia, maintained hemodynamic stability, excellent uterine relaxation, and reduced time of anesthesia induction, surgery, recovery, and extubation. In addition, compared with group L1.5, group L1.0 was more secure and worthy of clinical promotion in laparoscopy.

Keywords: Anesthesia, General, Anesthesia, Epidural, Anesthesia Recovery Period, Dose-Response Relationship, Drug, Epinephrine - blood, Hemodynamics, Hormones - blood, Intraoperative Care, Laparoscopy, Norepinephrine - blood, Ovarian Neoplasms - surgery, Respiration, Stress, Psychological - blood

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750