Comparison of effects of combined spinal and epidural anesthesia versus total intravenous anesthesia in percutaneous nephroscope lithoipsy

W. Dong, Xianbing Zhao, Yongqiang Guo
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Abstract

Objective To compare the effects of combined spinal and epidural anesthesia (CSEA) and total intravenous anesthesia (TIVA) in percutaneous nephroscope lithoipsy (PCNL). Methods Sixty patients who underwent PCNL in Xuchang Central Hospital from June 2017 to March 2018 were selected as the study objects. All the patients were randomly divided into control group and study group, with 30 cases in each group. Patients in the control group were anesthetized with TIVA, and patients in the study group were anesthetized with CSEA. Before anesthesia, at 10 minutes, 20 minutes, 30 minutes and 60 minutes after operation started, and after operation, the heart rate, blood oxygen saturation and blood pressure levels of the patients in the two groups were compared and analyzed. The occurrence of adverse reactions, such as dyspnea, delayed recovery and hypothermia, were recorded and analyzed. The recovery time, total block time and onset time of anesthesia were observed. Results The recovery time and the onset time of anesthesia in the study group were (14.90±1.90) min, (25.54±7.90)s, respectively, which were significantly shorter than the (19.43±2.89)min, (38.10±10.09)s in the control group (P 0.05). The blood pressure and heart rate of the study group were lower than those of the control group at 10 min, 20 min, 30 min and 60 min after operation started (P<0.05). The incidence of adverse reactions in the study group was 16.67%(5/30), which was significantly lower than the 50.00%(15/30) in the control group (P<0.05). Conclusions CSEA can effectively reduce the incidence of postoperative adverse reactions, and shorten onset time of anesthesia, with high safety. Key words: Anesthetics; Combined spinal and epidural anesthesia; Anesthesia, intravenous; Percutaneous nephrolithotripsy
脊髓硬膜外联合麻醉与全静脉麻醉在经皮肾镜取石术中的效果比较
目的比较脊髓硬膜外联合麻醉(CSEA)与全静脉麻醉(TIVA)在经皮肾镜碎石术(PCNL)中的应用效果。方法选取2017年6月至2018年3月在许昌市中心医院行PCNL的患者60例作为研究对象。所有患者随机分为对照组和研究组,每组各30例。对照组采用TIVA麻醉,研究组采用CSEA麻醉。比较分析麻醉前、手术开始后10分钟、20分钟、30分钟、60分钟及术后两组患者的心率、血氧饱和度、血压水平。记录并分析呼吸困难、恢复迟缓、体温过低等不良反应的发生情况。观察麻醉恢复时间、总阻滞时间和麻醉起效时间。结果研究组麻醉恢复时间为(14.90±1.90)min,麻醉起效时间为(25.54±7.90)s,明显短于对照组的(19.43±2.89)min,(38.10±10.09)s (P < 0.05)。研究组在手术开始后10 min、20 min、30 min、60 min血压、心率均低于对照组(P<0.05)。研究组不良反应发生率为16.67%(5/30),显著低于对照组的50.00%(15/30)(P<0.05)。结论CSEA可有效降低术后不良反应的发生率,缩短麻醉起效时间,安全性高。关键词:麻醉药;脊髓硬膜外联合麻醉;静脉麻醉;经皮nephrolithotripsy
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