Greenbarg P E, Brown M D, Pallares V S, Tompkins J S, Mann N H
Department of Orthopaedics and Rehabilitation, University of Miami School of Medicine, Florida 33101.
J Spinal Disord. 1988;1(2):139-43.
A retrospective review of the hospital records of 80 patients undergoing elective lumbar spine surgery was performed, in order to determine the effect of anesthetic technique on various clinical parameters. Forty patients receiving epidural bupivacaine anesthesia were matched with 40 patients receiving general endotracheal anesthesia; these two groups were homogeneous based on age, sex, type of operative procedure, and number of spinal levels operated upon. Significant results included lower injectable narcotic requirements (p less than 0.001), lower incidence of postoperative urinary retention (p less than 0.01), and lower operative blood loss (p less than 0.1) for patients receiving epidural anesthesia. Epidural bupivacaine provided satisfactory anesthesia, and allowed intraoperative testing of lower extremity motor function. In a follow-up surgery, 38 of 40 patients who received epidural anesthesia were satisfied with the technique. For patients undergoing decompressive lumbar spine surgery, epidural bupivacaine anesthesia is an effective, well tolerated technique with several potential advantages, and an acceptable incidence of complications, as compared with general endotracheal anesthesia.
为了确定麻醉技术对各种临床参数的影响,对80例行择期腰椎手术患者的医院记录进行了回顾性研究。40例接受硬膜外布比卡因麻醉的患者与40例接受全身气管内麻醉的患者进行匹配;这两组患者在年龄、性别、手术类型和手术的脊柱节段数量方面具有同质性。显著结果包括接受硬膜外麻醉的患者所需注射用麻醉剂较少(p<0.001)、术后尿潴留发生率较低(p<0.01)以及术中失血量较少(p<0.1)。硬膜外布比卡因提供了满意的麻醉效果,并允许术中测试下肢运动功能。在一次后续手术中,40例接受硬膜外麻醉的患者中有38例对该技术感到满意。对于接受腰椎减压手术的患者,与全身气管内麻醉相比,硬膜外布比卡因麻醉是一种有效、耐受性良好且具有多种潜在优势以及并发症发生率可接受的技术。