The Effect Of Epidural Preemptive Analgesia On Stress Response Under Retroperitoneal Laparoscopic Surgery

Objective: To observe the effect of epidural preemptive analgesia anesthesia combined with general anesthesia and general anesthesia on stress response under retroperitoneal laparoscopic surgery.Methods: We divided 40 patients performed with urology surgery under retroperitoneal laparoscopic into epidural preemptive analgesia anesthesia combined with general anesthesia group (GE group) and general anesthesia group(G group) at random. Each group had 20 cases. In GE group, patients were performed with T10～T11 epidural puncture before general anesthesia induction, then infused with 10～15ml 0.2% Bupivacaine total for test and preemptive analgesia dose, maintain the level of analgesia to T4 or so. Other anaesthesia methods was same with Group G. In G group, we adjusted the concentration of influrance inhalation based on blood pressure and controled the depth of anesthesia during surgery. We monitored the changes of mean blood pressure (MAP), heart rate per minute (HR), ET and CGRP concentration of blood plasma before and after pneumoperitoneum.Results: There were no obvious increases of MAP, ET and CGRP in GE group after pneumoperitoneum compared with pre-operation. In G group, MAP, HR, ET and CGRP were obviously higher than pre-operation, which were also higher than that of in GE group. HR in both groups presented slightly increase compared with pre-operation, which had no difference in both groups. The intra-operative isoflurane inhaled MAC and post-operative extubation time in GE group were obviously lower than that of in G group.Conclusion: There were strong stress response in intra-operative under retroperitoneal laparoscopic with general anesthesia. And epidural preemptive analgesia anesthesia combined with general anesthesia could effectively alleviate this kind of intra-operative stress response in surgery.