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| Application of anesthesia management in lumbar spine surgery under the concept of enhanced recovery after surgery |
| QIAO Liyan HAO Zhanyuan ZUO Ling |
| Department of Anesthesia, Jizhong Energy Xingtai Mining Group General Hospital, Hebei Province, Xingtai 054001, China |
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Abstract Objective To explore the clinical effects of anesthesia management under the guidance of the concept of enhanced recovery after surgery (ERAS) on patients undergoing lumbar surgery. Methods A total of 80 patients with lumbar degenerative disease who underwent posterior lumbar decompression, bone grafting, fusion and internal fixation from March to August 2019 in Jizhong Energy Xingtai Mining Group General Hospital were selected and divided into control group and ERAS group according to the random number table method, with 40 cases in each group. The control group was adopted conventional anesthesia management, and the ERAS group was adopted the ERAS concept of anesthesia management. The intraoperative vital signs of the two groups were compared, including mean arterial pressure (MAP), heart rate (HR), postoperative wake-up time, orientation recovery time and extubation time, intraoperative opioid dosage, and postoperative adverse reactions (chills, nausea and vomiting), visual analogue scale (VAS) at different time points after surgery, and the length of hospital stay. Results The comparison of MAP and HR group, time and interaction between the two groups were statistically significant (P ＜ 0.05). Among them, there was no statistically significant differences in MAP and HR in the ERAS group at each time point (P ＞ 0.05). The comparison of MAP at each time point in the control group showed statistically significant differences (P ＜ 0.05); except for 1, 2 h, the HR comparison at other time points showed statistically significant differences (P ＜ 0.05). The MAP and HR of the ERAS group were lower than those of the control group at each time point, and the differences were statistically significant (P ＜ 0.05). The incidence of postoperative adverse reactions including nausea and vomiting, chills in the ERAS group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The dosage of sufentanil in the ERAS group was lower than that in the control group, and the difference was statistically significant (P < 0.05). The postoperative recovery time, orientation recovery time, extubation time after operation and hospital stay in the ERAS group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). The VAS score of the ERAS group was lower than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion The application of anesthesia management guided by the concept of ERAS in lumbar surgery can make the patient’s vital signs more stable during the operation, shorten the patient’s recovery time after the operation, reduce the use of opioids, and decrease the incidence of postoperative adverse reactions. It is worthy of clinical application in spinal surgery.
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