Affiliated Hospital of Hebei Engineering University, Handan, 056002 Hebei, China.
Biomed Res Int. 2022 Aug 21;2022:9160145. doi: 10.1155/2022/9160145. eCollection 2022.
This work is aimed at evaluating the efficacy and safety of general anesthesia (GA) combined with spinal anesthesia (SA) (GA+SA) in elderly patients with chronic obstructive pulmonary disease (COPD). . 50 elderly COPD patients were rolled randomly into a control group (simple GA) and observation group (GA+SA). The differences in operation time, postoperative recovery time (PRT), language expression time (LET), anesthetic dosage (AD), catheter extubation time (CET), respiratory circulation indicators (mean arterial pressure (MAP), heart rate (HR), SaO, and PaO), postoperative VRS score, pulmonary function (forced vital capacity (FVC)), forced expiratory volume in 1 s (FEV1)/FVC and forced expiratory flow (FEF 25%~75%), serum inflammatory factors (IL-6, IL-8, and TNF-), Short Portable Mental Status Questionnaire (SPMSQ) score, and the incidence of respiratory system events were analyzed.
The results showed that the PRT, LET, AD, and CET of the observation group were all shorter ( < 0.05). The postoperative MAP, HR, SaO, and PaO levels of patients who received GA+SA were much higher than those who received simple GA ( < 0.05). The postoperative VRS score of the observation group was better than that of the controls ( < 0.05). The postoperative pulmonary function of patients in the observation group was better compared with that in the control group ( < 0.05). The postoperative serum inflammatory factors in the observation group were lower in contrast to the patients who received simple GA ( < 0.05). The postoperative cognitive function SPMSQ score of patients who received GA+SA was lower compared with the score of patients who received simple GA ( < 0.05). However, the probability of respiratory system events in the observation group was lower ( < 0.05).
In conclusion, GA+SA could significantly shorten the PRT and improve the recovery quality of elderly COPD patients. It can also reduce the postoperative inflammatory response and strengthen the pulmonary function and cognitive function. It also enhances the analgesic which is beneficial to patients' postoperative recovery. Therefore, GA+SA was a highly effective and safe anesthesia method for elderly patients with COPD, and it was worthy of clinical application.
本研究旨在评估全身麻醉（GA）联合椎管内麻醉（SA）（GA+SA）在老年慢性阻塞性肺疾病（COPD）患者中的疗效和安全性。
将 50 例老年 COPD 患者随机分为对照组（单纯 GA）和观察组（GA+SA）。比较两组患者的手术时间、术后恢复时间（PRT）、语言表达时间（LET）、麻醉剂量（AD）、导管拔出时间（CET）、呼吸循环指标（平均动脉压（MAP）、心率（HR）、SaO2 和 PaO2）、术后视觉模拟评分（VRS）、肺功能（用力肺活量（FVC））、第 1 秒用力呼气量（FEV1）/FVC 和呼气流量（FEF 25%~75%））、血清炎症因子（IL-6、IL-8 和 TNF-）、简易精神状态检查量表（SPMSQ）评分和呼吸系统事件发生率。
观察组 PRT、LET、AD 和 CET 均明显短于对照组（<0.05）。GA+SA 组患者术后 MAP、HR、SaO2 和 PaO2 水平明显高于单纯 GA 组（<0.05）。观察组术后 VRS 评分明显优于对照组（<0.05）。观察组患者术后肺功能明显优于对照组（<0.05）。观察组术后血清炎症因子明显低于单纯 GA 组（<0.05）。GA+SA 组患者术后认知功能 SPMSQ 评分明显低于单纯 GA 组（<0.05）。但观察组呼吸系统事件发生率明显低于对照组（<0.05）。
综上所述，GA+SA 可明显缩短 PRT，提高老年 COPD 患者的康复质量。还可以降低术后炎症反应，增强肺功能和认知功能。同时，增强镇痛作用，有利于患者术后恢复。因此，GA+SA 是一种治疗老年 COPD 患者的高效、安全的麻醉方法，值得临床应用。
