Volume 19 Issue 9
Sep.  2021
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JIN Xue-ting, ZHA Xiao-liang, QIU Zheng-hong, CHEN Fang, ZHANG Rong-yi, WANG Li-kui. Comfort and safety of patients undergoing percutaneous endoscopic lumbar discectomy with different anaesthesia methods[J]. Chinese Journal of General Practice, 2021, 19(9): 1484-1487. doi: 10.16766/j.cnki.issn.1674-4152.002092
Citation: JIN Xue-ting, ZHA Xiao-liang, QIU Zheng-hong, CHEN Fang, ZHANG Rong-yi, WANG Li-kui. Comfort and safety of patients undergoing percutaneous endoscopic lumbar discectomy with different anaesthesia methods[J]. Chinese Journal of General Practice, 2021, 19(9): 1484-1487. doi: 10.16766/j.cnki.issn.1674-4152.002092

Comfort and safety of patients undergoing percutaneous endoscopic lumbar discectomy with different anaesthesia methods

doi: 10.16766/j.cnki.issn.1674-4152.002092
Funds:

 1808085MH310

  • Received Date: 2020-09-24
    Available Online: 2022-02-15
  •   Objective  To investigate the effects of different anaesthesia methods on the comfort and safety of patients undergoing percutaneous endoscopic lumbar discectomy (PELD).   Methods  From February 2017 to May 2020, 60 patients with lumbar intervertebral disc herniation who planned to undergo PELD in the Department of Pain, Chaohu Hospital, Anhui Medical University, were divided into experimental group (M group) and control group (L) using a random number table method, with 30 cases in each group. In addition to the different anaesthesia methods, the surgical instruments, surgical methods and monitoring indicators used in both groups were the same. The L group was treated with 0.5% lidocaine for local infiltration anaesthesia, whilst the M group received continuous intravenous injection of dexmedetomidine and remifentanil on the basis of the L group. The NRS score, maximum value of MAP and HR of patients with low back pain in four time periods, entrance (T0), intraoperative puncture (T1), foramen expansion (T2) and microscopic operation (T3) were recorded. The rate of change of MAP and HR at T1, T2 and T3 compared with T0 was calculated. The occurrence of respiratory depression, postoperative vomiting and urinary retention during the operation was recorded. The satisfaction survey of patients was carried out after the operation.   Results  Both groups of patients had pain in the lower back and back during the operation. Compared with the L group, the NRS pain score of the M group was significantly lower. Compared with the change rate of MAP and HR (ΔMAP, ΔHR), the difference was statistically significant (all P < 0.05). Comparing the two groups of patients, no statistically significant difference was observed in the incidence of intraoperative respiratory depression, postoperative urinary retention and postoperative vomiting (all P>0.05). The satisfaction score of the M group [(8.2±0.9) points] was significantly higher than that [(4.1±1.1) points] of the L group, and the difference was statistically significant (P < 0.05).   Conclusion  PELD with intravenous-assisted analgesia and sedation can provide patients with better analgesia and sedation, with significantly improved comfort. Moreover, it does not increase the incidence of complications, has high safety and is worthy of clinical promotion.

     

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