Effects of epidural anesthesia combined with general anesthesia on hemodynamics,tissue oxygenation and anesthetic dose in patients undergoing laparoscopic radical surgery for colorectal cancer

Objective To observe effects of epidural anesthesia combined with general anesthesia on hemodynamics, tissue oxygenation and anesthetic dose in patients undergoing laparoscopic radical surgery for colorectal cancer. Methods Eighty-eight patients who underwent laparoscopic radical surgery for colorectal cancer were enrolled. According to non-randomized clinical controled study and well-informed voluntary principle, they were divided into observation group(epidural anesthesia combined with general anesthesia)and control group(general anesthesia), with 44 cases in each group. Changes of mean arterial pressure(MAP)and heart rate(HR)after entering to the room(T₀), at 10 min after tracheal intubation(T₁), at 1 h after establishing pneumoperitoneum(T₂), at 2 h after establishing pneumoperitoneum(T₃), at 10 min after closing pneumoperitoneum(T₄), at extubation time(T₅)during perioperation were observed. At T₀, T₂, T₃ and T₅, arterial blood gas analysis was conducted. The pulse oximetric saturation(SpO₂)and arterial oxygen pressure［p(O₂)］ were recorded, and intrapulmonary shunt ratio(QS/QT)was calculated. The anesthetic dose, postoperative recovery and incidence of adverse reactions were compared between the two groups. - Results At T₂, T₃ and T₅, the values of MAP in observation group were significantly lower, and HR at T₂ and T₃ was significantly lower than that in control group(P<0.05). At T₂, T₃ and T₅, QS/QT in observation group was significantly lower, while SpO₂ and p(O₂)were significantly higher than those in control group(P<0.05). The doses of anaesthetic drugs such as propofol, remifentanil and cisatracurium in observation group were significantly less, and recovery time as well as extubation time were significantly earlier than those in control group(P<0.05). There was no significant difference in incidence of adverse reactions between the two groups(P>0.05). Conclusion The application of epidural anesthesia combined with general anesthesia in laparoscopic radical surgery for colorectal cancer can effectively maintain stability of intraoperative hemodynamics, improve tissue oxygenation function, reduce anesthetic dose, and promote patients'recovery.