To investigate the effects of general anesthesia combined with continuous epidural infusion of 0.1% ropivacaine on concentration of plasma cortisol in patients of endoscopic thyroidectomy via breast approach.

Forty cases undergoing endoscopic thyroidectomy were randomly divided into 2 groups (20 in each group). Patients in Group A were under total intravenous anesthesia. Before induction, patients in Group B were inserted the epidural catheter followed with continuous infusion of 0.1% ropivacaine (2 ml/h). MAP, HR, Cor changes of all patients were recorded before anesthesia (T₀), 5 min after intubation (T₁), 60 min after incision (T₂), 5 min after extubation (T₃). VAS were recorded 6 h (T₄), 12 h (T₅), and 24 h (T₆) after the operation. Intraoperative dosage of propofol and remifentanil, extubation time and bolus times of postoperative patient-controlled analgesia were recorded.

Compared with T₀, MAP and HR of all patients at T₁ and HR at T₂ and T₃ reduced, while Cor increased; MAP of patients in Group B were decreased (P<0.05). Compared with Group A, MAP and HR at T₁ and Cor at T₂ and T₃ in Group B decreased (P<0.05). Compared with T₄, VAS of patients in Group A at T₅ increased (P<0.05); compared with T₅, VAS of all patients at T₆ decreased (P<0.05). Compared with group A, VAS of patients in Group B at T₅ decreased (P<0.05), dosage of propofol and remifentanil, extubation time and bolus times of PCA were decreased (P<0.05).

General anesthesia combined with continuous epidural infusion of 0.1% ropivacaine in patients of endoscopic thyroidectomy via breast approach can improve efficacy of intraoperative stress and postoperative analgesia, and reduce the demand of anesthetic drug.