后路单椎体全脊椎整块切除术的麻醉处理

目的总结后路单椎体全脊椎整块切除术的麻醉处理经验。方法对2009年1月～2010年12月所做的15例全脊椎整块切除术的麻醉处理进行分析。结果术中3例患者术中发生较大量出血和严重的低血压;1例发生明显输异体血反应。全部患者术后均苏醒迅速、完全,拔管后安返病房。术后苏醒期有1例患者出现烦躁不能耐受导尿管;1例患者术后48 h内疼痛视觉模拟量表（visual analogue scale,VAS）评分3分,其余均在1～2分。术后输血量≤2单位浓缩红细胞。结论单椎体全脊椎整块切除术的麻醉要特别注意术中出血的管理,维持循环与呼吸的稳定。同时要做好术后镇痛的管理,良好的镇痛是减少术后发生并发症的有力措施。

Anesthesia for total en bloc spondylectonmy of single vertebral body via posterior approach

Objective To summarize our experience in anesthesia management for total en bloc spondylectonmy(TES) of single vertebral body through a posterior approach.Methods The anesthesia managements of 15 patients receiving TES of a single vertebral body in our hospital from January 2009 to December 2010 were analyzed retrospectively.Results Intraoperative hemorrhoea and severe hypotension occurred in 3 patients.One patient had obvious allogenic blood transfusion reactions.All patients recovered quickly and then returned to patients’ room after safe extubation.One patient had irritability-restlessness and wasn’t tolerant with catheter in stage of analepsia.One patient scored 3 by visual analogue scales(VAS),other patients scored VAS 1-2 within 48 h after operation.Blood transfusion of concentrated red blood cells was ≤ 2 units for all patients.Conclusion Special attention should be paid to blood loss during total en bloc spondylectonmy of single vertebral body to maintain circulation and respiratory for anesthesia.Moreover,postoperative analgesia is of great importance to reduce postoperative complications.