全凭静脉麻醉和吸入麻醉在脊柱手术中的应用效果观察

Application effect of total intravenous anesthesia and inhalation anesthesia in spinal surgery

目的 探讨全凭静脉麻醉和吸入麻醉在脊柱手术中的应用效果。方法 98例脊柱手术患者,采用随机数字表法分为吸入麻醉组和全凭静脉麻醉组,每组49例。全凭静脉麻醉组应用瑞芬太尼、丙泊酚推注泵连续输注,吸入麻醉组应用七氟醚持续吸入维持麻醉。比较两组患者麻醉优良率,自主呼吸恢复时间和血氧饱和度,认知功能障碍发生情况。结果 全凭静脉麻醉组的麻醉优良率为97.96%,而吸入麻醉组的麻醉优良率为85.71%;全凭静脉麻醉组的麻醉优良率高于吸入麻醉组,差异具有统计学意义(P<0.05)。全凭静脉麻醉组自主呼吸恢复时间(10.49±2.17)min短于吸入麻醉组的(14.10±2.34)min,血氧饱和度(97.49±2.17)%高于吸入麻醉组的(96.21±2.01)%,差异具有统计学意义(P<0.05)。全凭静脉麻醉组发生认知功能障碍1例,占比为2.04%;而吸入麻醉组发生认知功能障碍6例,占比为12.24%。全凭静脉麻醉组认知功能障碍发生率低于吸入麻醉组,差异具有统计学意义(P<0.05)。结论 脊柱手术患者实施全凭静脉麻醉效果确切,优于吸入麻醉,效果确切,可加速患者恢复,值得推广。

Objective To discuss the application effect of total intravenous anesthesia and inhalation anesthesia in spinal surgery.Methods A total of 98 patients with spinal surgery were randomly divided into inhalation anesthesia group and total intravenous anesthesia group,with 49 cases in each group.The total intravenous anesthesia group received continuous infusion of remifentanil and propofol through venous pump,and the inhalation anesthesia group received continuous inhalation of sevoflurane to maintain anesthesia.The excellent and good rate of anesthesia,recovery time of spontaneous breathing,blood oxygen saturation,and the occurrence of cognitive dysfunction were compared between the two groups.Results The excellent and good rate of anesthesia in the total intravenous anesthesia group was 97.96%,while that in the inhalation anesthesia group was 85.71%;the excellent and good rate of anesthesia in the total intravenous anesthesia group was higher than that in the inhalation anesthesia group,and the difference was statistically significant(P<0.05).The recovery time of spontaneous breathing(10.49±2.17)min in the total intravenous anesthesia group was shorter than(14.10±2.34)min in the inhalation anesthesia group,and the blood oxygen saturation(97.49±2.17)%was higher than(96.21±2.01)%in the inhalation anesthesia group.All the differences were statistically significant(P<0.05).Cognitive dysfunction occurred in 1 case in the total intravenous anesthesia group,accounting for 2.04%;and cognitive dysfunction occurred in 6 cases in the inhalation anesthesia group,accounting for 12.24%.The incidence of cognitive dysfunction in the total intravenous anesthesia group was lower than that in the inhalation anesthesia group,and the difference was statistically significant(P<0.05).Conclusion The effect of total intravenous anesthesia in patients with spinal surgery is better than that of inhalation anesthesia,which can accelerate the recovery of patients and is worthy of promotion.