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择期腰椎手术中脊髓麻醉与全身麻醉的比较:一项随机临床试验。

Spinal anesthesia versus general anesthesia for elective lumbar spine surgery: A randomized clinical trial.

作者信息

Attari Mohammad Ali, Mirhosseini Sayyed Ahmad, Honarmand Azim, Safavi Mohammad Reza

机构信息

Associate Professor of Anesthesiology, School of Medicine and Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2011 Apr;16(4):524-9.

Abstract

BACKGROUND

Either general or regional anesthesia can be used for lumbar disk surgery. The common anesthetic technique is general anesthesia (GA). The aim of this study was to compare the intra and postoperative outcomes of spinal anesthesia (SA) with GA in these patients.

METHODS

Seventy-two patients were enrolled in the study. They were randomized into two groups with 37 patients in GA Group and 35 ones in SA Group. The heart rate (HR), mean arterial pressure (MAP), blood loss, surgeons satisfaction with the operating conditions, the severity of postoperative pain based on visual analogue scale (VAS) and analgesic use were recorded.

RESULTS

The mean blood loss was significantly less in the SA Group compared to GA Group (p < 0.05). Intraoperative maximum blood pressure and heart rate changes were significantly less in SA Group (p < 0.05). The surgeons satisfaction was significantly more in the SA Group (p < 0.05). The number of patients who used postoperative analgesic as well as postoperative mean VAS was significantly less in SA Group in comparison with GA group (p < 0.05 for both).

CONCLUSIONS

Our study showed that SA was superior to GA in providing postoperative analgesia and decreasing blood loss while maintained better perioperative hemodynamic stability without increasing adverse side effects.

摘要

背景

全身麻醉或区域麻醉均可用于腰椎间盘手术。常见的麻醉技术是全身麻醉(GA)。本研究的目的是比较这些患者中脊髓麻醉(SA)与全身麻醉的术中及术后结果。

方法

72例患者纳入本研究。他们被随机分为两组,全身麻醉组37例,脊髓麻醉组35例。记录心率(HR)、平均动脉压(MAP)、失血量、外科医生对手术条件的满意度、基于视觉模拟评分法(VAS)的术后疼痛严重程度及镇痛药物使用情况。

结果

与全身麻醉组相比,脊髓麻醉组的平均失血量显著更少(p < 0.05)。脊髓麻醉组术中最大血压和心率变化显著更小(p < 0.05)。脊髓麻醉组外科医生的满意度显著更高(p < 0.05)。与全身麻醉组相比,脊髓麻醉组术后使用镇痛药物的患者数量以及术后平均VAS评分均显著更低(两者均p < 0.05)。

结论

我们的研究表明,脊髓麻醉在提供术后镇痛和减少失血量方面优于全身麻醉,同时在围手术期保持更好的血流动力学稳定性且不增加不良反应。

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本文引用的文献

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