OBJECTIVETo evaluate the effect of epidural anesthesia and patient-controlled epidural analgesia (PCEA) on hemorheology and the incidence of deep venous thrombosis in patients undergoing gynecological laparoscopy.

METHODSOne hundred ASA I-II patients undergoing gynecological laparoscopy were randomly allocated into 2 groups to receive general-epidural anesthesia combined with PCEA (GE group) and general anesthesia (G group). Blood samples were taken before anesthesia (T(0)), before operation (T(1)), 30 min after pneumoperitoneum (T(2)), 30 min after pneumoperitoneum cease (T(3)), and 24 and 48 h after the operation (T(4), T(5)) for hemorheological tests.

RESULTSIn GE group, the blood viscosity, plasma viscosity and RBC aggregation decreased significantly at T(1) (P<0.05), but no significant variations were detected at the other time points. In G group, blood viscosity and plasma viscosity increased significantly from T(2) to T(5), and were significantly higher than those of GE group. The incidence of deep venous thrombosis of GE group (2%) was significantly lower than that of the G group (8%).

CONCLUSIONThe blood viscosity, plasma viscosity and RBC aggregation increase during gynecological laparoscopy, and can be reduced by epidural anesthesia and PCEA to lower the incidence of deep venous thrombosis.