ANALGESIC EFFICACY OF COMBINED SPINAL-EPIDURAL WITH GENERAL ANESTHESIA DURING AND AFTER LAPAROSCOPIC COLORECTAL SURGERY
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Abstract
Background: Combined spinal-epidural with general anesthesia helps reducing opioid dose and volatile anesthetics concentration during surgery, by other words helps stabilize hemodynamics better, reduce the dose of medication used during surgery, reduce pain more effectively, can awaken earlier, allow early withdrawal of endotracheal tube and reduce complications due to pain and deep anesthesia. Objectives: to evaluate the analgesic effects and side effects of combined spinal- epidural with general anesthesia during and after laparoscopic colorectal surgery. Materials and method: a prospective cross – sectional study, was conducted on 62 patients indicated for laparoscopic colorectal surgery at Can Tho University of Medicine and Pharmacy Hospital from April, 2017 to June, 2018. Results: At any time after surgery, when the patient mobilized, more analgesics were needed (VAS 4 points). When the patient did not mobilize: the need for more pain medicine only appeared 1 hour or 2 hours after surgery Side effects: Hypotension accounted for the highest percentage with 46.77%. Increased EtCO2 accounted for 41.94%, usually the highest increase after CO2 insufflation 30 minutes, 60 minutes and at the end of surgery. Other side effects include: bradycardia 19.35%, increase BP 8.06%. There was 1 case of bronchospasm during surgery, accounting for 1.61%. Conclusion: Combined spinal-epidural with general anesthesia is a safe and effective method of anesthesia for long-term pain relief, so it should be applied routinely in laparoscopic colorectal surgery.
Keywords
Combined spinal-epidural anesthesia (CSE), laparoscopic colorectal surgery
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References
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