Effects of Ropivacaine Combined with Fentanyl Spinal Anesthesia and Bupivacaine Spinal Anesthesia on Anesthesia Effect and Postoperative Analgesia of Elderly Patients Undergoing Percutaneous Transforaminal Endoscopic Discectomy
YANG Baizhu,YANG Lulu
The Second Affiliated Hospital of Shenyang Medical College, Liaoning Shenyang 110036, China
Abstract：Objective: To analyze the effects of ropivacaine combined with fentanyl spinal anesthesia and bupivacaine spinal anesthesia on the anesthesia effect and postoperative analgesia of elderly patients undergoing percutaneous transforaminal endoscopic discectomy. Methods: 149 elderly patients who underwent percutaneous transforaminal endoscopic discectomy in this hospital between July 2019 and July 2020 were divided into control group (n=74) and observation group (n=75) with the random number table method. The control group underwent percutaneous transforaminal endoscopic discectomy under spinal anesthesia with pure bupivacaine, and the observation group underwent percutaneous transforaminal endoscopic discectomy under spinal anesthesia with ropivacaine combined with fentanyl. The anesthesia effect, postoperative analgesia effect, stress response indicators and postoperative cognitive function of the two groups were compared. Results: The anesthesia onset time, anesthesia block completion time and anesthesia recovery time of observation group were all faster than those of control group (P<0.05). At 4h, 12h and 24h after surgery, the postoperative sedation score (Ramsay) and facial expression grading score (FRS) were lower in observation group than those in control group (P<0.05). There were no statistical differences in the heart rate (HR), blood oxygen saturation (SpO2) and mean arterial pressure (MAP) in observation group compared with those before anesthesia (P<0.05), and the above values at 2h and 4h after anesthesia were higher than those in control group (P<0.05). At 7d, 14d and 28d after surgery, the Montreal Cognitive Assessment Scale (MoCA) score of observation group was significantly higher than that of control group (P<0.05). Conclusion: Percutaneous transforaminal endoscopic discectomy under ropivacaine combined with fentanyl spinal anesthesia has better anesthesia effect and postoperative analgesia effect than surgery under bupivacaine spinal anesthesia, and the former one can more effectively reduce the intraoperative stress response and has less impact on cognitive function of patients, thus it is worthy of clinical promotion.
2022, Vol. 28 
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