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全身麻醉与硬膜外/全身联合麻醉用于择期腰椎间盘手术的比较:一项比较两种方法对结果变量影响的随机临床试验。

General anesthesia versus combined epidural/general anesthesia for elective lumbar spine disc surgery: A randomized clinical trial comparing the impact of the two methods upon the outcome variables.

作者信息

Khajavi Mohammad Reza, Asadian Mohammad Amir, Imani Farsad, Etezadi Farhad, Moharari Reza Shariat, Amirjamshidi Abbas

机构信息

Department of Anaesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Surg Neurol Int. 2013 Aug 19;4:105. doi: 10.4103/2152-7806.116683. eCollection 2013.

Abstract

BACKGROUND

General anesthesia (GA) is the most frequently used technique for lumbar spine disc surgery. The aim of this study was to compare the intraoperative variables and postoperative outcome after GA and combined general/epidural anesthesia (CEG) in patients undergoing elective lumbar spine disk surgery.

METHODS

Eighty patients who underwent one or two level of laminectomy/discectomy during a 2 year period were enrolled in this randomized controlled trial (RCT). They were randomly selected to undergo GA or CEG. The data recorded during surgery were: The patients' heart rate (HR), mean arterial blood pressure (MABP), amount of blood loss, and the medication used during anesthesia. The severity of pain score, total analgesic consumption, and complications were recorded in the postoperative period.

RESULTS

The MABP, HR, blood loss, and anesthetic medication were significantly lower in CEG group in comparison with that of GA group. In the postoperative period, the pain score and total analgesic requirement was lower in the CEG group and less complication were encountered in this group.

CONCLUSION

The results of this study revealed that CEG have some advantages over GA in reducing the blood loss and anesthetic medication during the operation and it is also more effective in control of pain with fewer complications during the postoperative period.

摘要

背景

全身麻醉(GA)是腰椎间盘手术中最常用的技术。本研究的目的是比较择期腰椎间盘手术患者在全身麻醉和全身/硬膜外联合麻醉(CEG)后的术中变量和术后结果。

方法

80例在2年期间接受一或两个节段椎板切除术/椎间盘切除术的患者被纳入这项随机对照试验(RCT)。他们被随机选择接受全身麻醉或全身/硬膜外联合麻醉。手术期间记录的数据包括:患者的心率(HR)、平均动脉血压(MABP)、失血量以及麻醉期间使用的药物。术后记录疼痛评分的严重程度、总镇痛药物消耗量和并发症情况。

结果

与全身麻醉组相比,全身/硬膜外联合麻醉组的平均动脉血压、心率、失血量和麻醉药物用量显著降低。在术后期间,全身/硬膜外联合麻醉组的疼痛评分和总镇痛需求较低,且该组遇到的并发症较少。

结论

本研究结果表明,全身/硬膜外联合麻醉在减少手术期间的失血量和麻醉药物用量方面比全身麻醉具有一些优势,并且在术后期间控制疼痛方面更有效,并发症更少。

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