Effect of general anesthesia combined with epidural block on the stress reaction in patients treated with laparoscopic hysterectomy

Objective: To observe the effects of general anesthesia combined with epidural block on the stress reaction in patients treated with laparoscopic hysterectomy.Methods: Forty patients treated with laparoscopic hysterectomy were randomly divided into the general anesthesia combined with epidural block group(observation group) and general anesthesia group(control group)(20 cases each group).The control group were induced by intravenous injection with 0.2 mg/kg of midazolam,4 μg/kg of fentanyl,0.6 mg/kg of rocuronium and 0.2 mg/kg of etomidate,the respirator controlled the breath to maintain end-tidal pressure of carbon dioxide for 30 to 35 mmHg,the anesthesia was maintained by intravenous injection with rocuronium,8 mg·kg^-1·h^-1 of propofol and 0.2 μg·kg^-1·min^-1 of remifentanil.The observation group were treated with epidural anesthesia combined with general anesthesia,the sedation was maintained by intravenous injection with 0.03 mg/kg of midazolam at 10 minutes before epidural block,the 5 ml of 2% lidocaine was injected into between L2 and L3 for observing 5 to 10 min,and 10 ml of 0.75% ropivacaine was injected into epidural space.The induction drug of general anesthesia in control group was the same as the observation group.The serum levels of adrenaline and noradrenaline,mean arterial pressure and heart rate were detected before operation,skin incision,at pneumoperitoneum 20 min and postoperative 10 min.Results: The differences of all indexes in two groups before operation were not statistically significant(P>0.05).The serum levels of adrenaline and noradrenaline,mean arterial pressure and heart rate in observation group at pneumoperitoneum 20 min and postoperative 10 min were lower than those in control group(P<0.05 to P<0.01).The anesthesia satisfaction in observation group was higher than that in control group(P<0.01).Conclusions: Compared with general anesthesia,the general anesthesia combined with epidural block can effectively inhibit the stress reactions in patients treated with laparoscopic hysterectomy.