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全身麻醉与局部麻醉在腰椎间孔镜手术中的效果比较。

Comparison of the effects of general and local anesthesia in lumbar interlaminar endoscopic surgery.

作者信息

Ye Xue-Fei, Wang Sheng, Wu Ai-Min, Xie Lin-Zheng, Wang Xiang-Yang, Chen Jiao-Xiang, Xu Hui, Sheng Sun-Ren

机构信息

Department of Anesthesiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.

Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.

出版信息

Ann Palliat Med. 2020 May;9(3):1103-1108. doi: 10.21037/apm-20-623. Epub 2020 May 18.

Abstract

BACKGROUND

Percutaneous endoscopic lumbar discectomy (PELD) with an interlaminar approach is a technique used to treat lumbar disc hernia. It has not yet been established whether general or local anesthesia (LA) is preferable for lumbar interlaminar endoscopic surgery.

METHODS

Between October, 2012 and June, 2016, 60 patients were recruited and randomly divided into 2 groups: the general anesthesia (GA) group and the LA group. The patients' basic clinical data, intraoperative patient experience, Oswestry disability index (ODI), visual analog scale (VAS) score, and the postoperative patient satisfaction rate were assessed.

RESULTS

Statistically significant differences were found between the two groups in operative time and length of hospital stay. There were no significant differences in postoperative ODI or VAS scores between the two groups during follow-up at 3, 6, and 12 months. One patient in the GA group sustained a nerve root injury intraoperatively. Two patients in the LA group suffered adverse reactions, as did six patients in the GA group. However, 50% of the patients expressed fear about undergoing the surgery with LA, while all patients felt they could undergo the same surgery with GA.

CONCLUSIONS

General and LA are both suitable for use in lumbar interlaminar endoscopic surgery. However, GA makes a positive intraoperative surgical experience more likely for the patient.

摘要

背景

经皮内镜下腰椎间盘切除术(PELD)的椎板间入路是一种用于治疗腰椎间盘突出症的技术。对于腰椎椎板间内镜手术,全身麻醉还是局部麻醉(LA)更可取,目前尚未确定。

方法

2012年10月至2016年6月期间,招募了60例患者并随机分为两组:全身麻醉(GA)组和LA组。评估患者的基本临床资料、术中患者体验、Oswestry功能障碍指数(ODI)、视觉模拟量表(VAS)评分以及术后患者满意度。

结果

两组在手术时间和住院时间上存在统计学显著差异。在术后3、6和12个月的随访期间,两组的术后ODI或VAS评分无显著差异。GA组有1例患者在术中发生神经根损伤。LA组有2例患者出现不良反应,GA组有6例患者出现不良反应。然而,50%的患者表示害怕接受LA手术,而所有患者都觉得他们可以接受GA下的相同手术。

结论

全身麻醉和LA都适用于腰椎椎板间内镜手术。然而,GA使患者在术中获得更积极的手术体验的可能性更大。

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