重比重罗哌卡因腰麻在腰椎棘突间稳定器植入术中的应用  

Application of spinal anesthesia with hyperbaric ropivacaine in lumbar interspinous process stabilizer device implantation

作　　者：李延培 孙磊 朱琛 LI Yan-pei;SUN Lei;ZHU Chen(Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《临床和实验医学杂志》2024年第15期1678-1680,F0003,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨重比重罗哌卡因腰麻用于腰椎棘突间稳定器植入术的可行性。方法前瞻性选取2020年9月至2023年9月首都医科大学附属北京友谊医院80例接受腰椎棘突间稳定器植入术的患者设为研究对象,将所有患者按照随机数字表法分为两组:全麻组(n=40)和腰麻组(n=40)。观察并记录两组患者的手术相关指标,包括手术时间、麻醉时间、手术失血量、术中心动过速与心动过缓、高血压、麻醉恢复室(PACU)停留时间。手术结束后利用视觉模拟评分法(VAS)评价术后疼痛强度,并观察术后麻醉并发症发生情况。结果两组患者的手术时间、麻醉时间、手术失血量、术中心动过速与心动过缓、高血压的发生率比较,差异均无统计学意义(P>0.05);腰麻组患者术中低血压发生率为17.50%,明显低于全麻组(42.50%),PACU停留时间为0,短于全麻组[(24.58±9.46)min],差异均有统计学意义(P<0.05)。腰麻组的术后VAS评分为(4.88±1.80)分,明显低于全麻组[(5.80±1.64)分],差异有统计学意义(P<0.05);两组患者的住院时间比较,差异无统计学意义(P>0.05)。两组患者术后恶心、呕吐、寒战发生率比较,差异均无统计学意义(P>0.05)。结论与全麻相比,单次给予重比重罗哌卡因腰麻可以应用于腰椎稳定器植入术,其麻醉效果无显著差异,而术中低血压发生率更低,术后镇痛效果更确切。Objective To investigate the feasibility of spinal anesthesia with hyperbaric ropivacaine for interspinous stabilizer implantation.Methods Eighty patients undergoing lumbar stabilizer implantation in Beijing Friendship Hospital,Capital Medical University from September 2020 to September 2023 were prospectively selected as the research objects.All patients were divided into two groups according to the random number table method:the general anesthesia group(n=40)and the spinal anesthesia group(n=40).The operation-related indicators of the two groups were observed and recorded,including operation time,anesthesia time,blood loss,intraoperative tachycardia and bradycardia,hypertension,and anesthesia recovery room(PACU)residence time.Postoperative pain intensity was evaluated by visual analogue scale(VAS)after the end of surgery,and the postoperative anesthetic complications was observed.Results There were no statistically significant differences in the operation time,anesthesia time,blood loss,intraoperative tachycardia and bradycardia,and the incidence of hypertension between the two groups(P>0.05).The incidence of intraoperative hypotension in the spinal anesthesia group was 17.50%,which was significantly lower than that in the general anesthesia group(42.50%),and the PACU residence time was 0,which was shorter than that in the general anesthesia group[(24.58±9.46)min],the differences were statistically significant(P<0.05).The postoperative VAS score of the spinal anesthesia group was(4.88±1.80)points,which was significantly lower than that of the general anesthesia group[(5.80±1.64)points],and the difference was statistically significant(P<0.05).There was no statistically significant difference in hospitalization days between the two groups(P>0.05).There was no statistically significant difference in the incidence of postoperative nausea,vomiting and chills between the two groups(P>0.05).Conclusion Spinal anesthesia with hyperbaric ropivacaine can be used for lumbar stabilizer implantation.Compared with general

关 键 词：腰椎棘突间稳定器植入术 腰麻 罗哌卡因 重比重液 

分 类 号：R614[医药卫生—麻醉学]