快速康复外科理念在脊柱后凸畸形矫形术麻醉管理中的应用

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Abstract Objective To observe the clinical effect of anesthesia management strategy under the concept of enhanced recovery after surgery (ERAS) in kyphosis deformity surgery. Methods A total of 50 patients with moderate or severe kyphosis deformity who underwent elective spinal osteotomy in the People′s Hospital of Fuyang in Anhui Province from January 2014 to November 2018 were enrolled, they were divided into two groups according to random number table method: ERAS group (group C, n = 25) and control group (group E, n = 25). Group C was given the traditional perioperative management method and group E was given the perioperative management mode under the concept of ERAS, such as preoperative functional exercise, intraoperative lung protection, goal-oriented fluid therapy, blood protection, temperature protection and other measures, postoperative multi-mode analgesia. The concentrations of blood glucose (Glu), cortisol (Cor) and level of C-reactive protein (CRP) were measured before anesthesia (T0), after extubation (T1), 24 h (T2) and 48 h after surgery (T3), respectively. The recovery time, intraoperative blood loss, and VAS score within 48 h were recorded. The recovery time of the intestines, the time of eating, and the number of hospital stays were recorded. And the occurrence of postoperative adverse reactions were observed. Results Compared with group C, the concentrations of Glu, Cor and level of CRP at the timepoint of T1-T3 were significantly lower in group E (P < 0.05). The recovery time, intraoperative blood loss and VAS score within 48 h were lower (P < 0.05). The intestinal recovery time, eating time and hospitalization time of patients were significantly shorter (P < 0.05). The number of patients with adverse reactions such as conjunctival edema and nausea and vomiting decreased after operation (P < 0.05). Conclusion The anesthesia management strategy under the concept of ERAS in kyphosis deformity surgery can significantly inhibit the patient′s stress response and provide a good analgesic effect. It can reduce fewer postoperative adverse reactions, and promote patients early recovery.

Key words： Enhanced recovery after surgery Kyphosis Spinal osteotomy Perioperative anesthesia management Stress response

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	CAI Ning1 DAI Chenxu1 YU Haiyang2 ZHANG Xu2

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CAI Ning1 DAI Chenxu1 YU Haiyang2 ZHANG Xu2. Application of the enhanced recovery after surgery concept of anesthesia management in kyphosis deformity surgery[J]. 中国医药导报, 2019, 16(22): 98-102.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I22/98

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