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首页> 外文期刊>The Egyptian Journal of Hospital Medicine >Total intravenous anaesthesia versus volatile induction and maintenance anaesthesia for controlled hypotension in lumbar spine fixation surgery: Comparative clinical study
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Total intravenous anaesthesia versus volatile induction and maintenance anaesthesia for controlled hypotension in lumbar spine fixation surgery: Comparative clinical study

机译：腰椎固定手术中全静脉麻醉与挥发性诱导和维持麻醉控制性低血压的对比临床研究

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Background: Controlled hypotension during general anesthesia aims to lower the mean arterial blood pressure (MAP) to values between 55 and 65 mmHg in patients with normal blood pressure, with the goal of significantly reducing blood loss by maintaining it at this level throughout the operation process. Controlled hypotension is frequently used for obtaining better exposure during spine surgery as small bleeding areas can produce better surgical field visibility and result in decreased time of surgery. Objective: This study was done to compare the efficacy and safety of TIVA and VIMA to induce hypotensive technique during spine surgery, with attention on the amount of blood loss, blood transfusion, hemodynamics, time of recovery and postoperative nausea and vomiting. Patients and Methods: This study included 40 patients of both sex, admitted for lumbar spine fixation surgery carried out at Al- Azhar University Hospitals (El-Hussein and Bab El-Sharia) . They were randomly allocated into two equal groups, 20 patients each (n= 20): Group I (TIVA); Total intravenous anaesthesia using (fentanyl and propofol). Group II (VIMA); Volatile induction and maintenance anesthesia (Inhalational anaesthesia) using (fentanyl and sevoflurane). Results: The following parameters were assessed between the 2 groups: Hemodynamics (HR, SBP, DBP and MAP), SPO2 and ET CO2 were continuously monitored and recorded at 15 min interval. Intraoperative blood loss, blood transfusion, duration of surgery, time of recovery and postoperative nausea and vomiting were monitored in all patients. Conclusion: this study showed that both TIVA and VIMA were effective in producing controlled hypotension for lumbar spinal fixation surgery. However, only TIVA was beneficial, allowing properly controlled hypotension, minimized intraoperative bleeding, and improved surgical field visibility compared to VIMA.
机译：背景：全麻期间控制性低血压旨在将血压正常的患者的平均动脉压（MAP）降低至55至65 mmHg，目的是通过在整个手术过程中将其维持在该水平，以显着减少失血。受控的低血压通常用于在脊柱手术中获得更好的暴露，因为小的出血区域可产生更好的手术视野，并减少手术时间。目的：本研究旨在比较TIVA和VIMA在脊柱手术中诱导降压技术的有效性和安全性，并关注失血量，输血量，血液动力学，恢复时间以及术后恶心和呕吐。患者和方法：这项研究包括40名男女患者，他们接受了Al-Azhar大学医院（El-Hussein和Bab El-Sharia）进行的腰椎固定手术。他们被随机分为两组，每组20名患者（n = 20）。使用（芬太尼和丙泊酚）进行完全静脉麻醉。第二组（VIMA）;使用（芬太尼和七氟醚）进行挥发性诱导和维持麻醉（吸入麻醉）。结果：在两组之间评估以下参数：连续15分钟监测并记录血流动力学（HR，SBP，DBP和MAP），SPO2和ET CO2。监测所有患者的术中失血，输血，手术时间，恢复时间以及术后恶心和呕吐。结论：这项研究表明，TIVA和VIMA均可有效地控制腰椎固定术的血压。但是，与VIMA相比，只有TIVA是有益的，它可以适当控制低血压，减少术中出血并改善手术视野。

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