Study On The Prevention Effects Of Dexamethasone For The Common Complications Caused By The Intravertebral Anesthesia

With the development of medical technology, anaesthesia methods were constantly improved and enhanced, there are more and more new methods and techniques applied in anesthesiology. At the same time, with the improvement of living standards and health consciousness were strengthened, the operation security and the risk of anesthesia in patients were paid more attention. Dexamethasone hormone is a kind of nonsteroidal anti-inflammatory, anti-allergic, anti-rheumatism,shock resistance and so on, widely used in clinic. But the effect of dexamethasone is not specificity, the research on the role of the common complications of spinal canal anesthesia research less, and did not reach a consensus.Objective:This study whether or not to use in patients with spinal canal anesthesia surgery postoperative comparing various adverse reactions of dexamethasone, and dexamethasone in the spinal canal anesthesia surgery the different method of postoperative adverse reaction case comparison, evaluation of dexamethasone the prevention of the complications of spinal canal anesthesia, provided the scientific basis for clinical anesthesia work.Methods:A total of 1941 patients who met inclusion and exclusion criteria and with spinal canal anesthesia in Qiqihar Jianhua Hospital between January 2015 and May2015.Access to medical records to collect general information of the research object,subordinate departments, operation way, smoking history, history of related data.Statistical anesthesia dexamethasone usage, in the process of collecting whether one to three days after surgery in patients with postoperative headache, low back pain after operation, postoperative nausea and vomiting, and so on and so forth, and intraoperative blood loss, operative time, blood pressure, heart rate, etc. A database of using excel, SPSS 19.0 statistical analysis software, the measurement data with mean+ /- standard deviation statistical description, using t test, the distribution of comparison between different groups; Count data using statistical description of composition ratio and rate, the distribution of the c2 inspection comparison between different groups. Single factor analysis and multiple factors Logistic regression analysis using dexamethasone impact on postoperative complications. All statistical tests for bilateral inspection, calibration for alpha = 0.05.Results:1.Of 1941 cases of the object of study, 1056 malecases(54.4%), 885 female cases(45.6%). The youngest patient was 20 years old, the biggest patient was 95 years old, the average age was(57.69 + /- 17.86) years old. Patients with spinal canal anesthesia using dexamethasone in 1059 patients(54.6%), among them 505 cases by intravenous dexamethasone,(26.0%), by spinal canal given dexamethasone in 554patients(28.5%). Appear in patients undergoing spinal canal anesthesia, postoperative back pain in 249 patients(12.8%), 200 cases of patients of postoperative headache(10.3%), 398 patients with occurrence of postoperative nausea and vomiting(20.5%),sedation anesthesia complications after a total of 703 cases(36.2%).2.The rate for at least one complication caused by the intravertebral anesthesia in without the use of dexamethasone, intravenous use of dexamethasone, intraspinal use of dexamethasone groups were 61.2%, 24.6%, 7.0%, respectively.3. For the common complications caused by the intravertebral anesthesia, the risk of intravenous injection of dexamethasone was 0.206-fold(95% CI: 0.162 ~ 0.263),the risk of dexamethasone spinal surgery was 0.048-fold(95% CI: 0.034 ~ 0.068).Either intravenous injection of dexamethasone or intraspinal administration, can significantly reduce the common complications caused by the intravertebral anesthesia. The intraspinal routes could reduce the common complications better.4. The single factor analysis of what is happening intra-spinal canal anesthesia complications: patients’ age, type of operation, operation time, whether suffering from infectious diseases, blood loss, whether combined diabetes mellitus and hypertension in patients with spinal canal anesthesia occurrence of postoperative headache have statistical significance. Patients’ age, type of operation, operation time, blood loss,whether combined diabetes mellitus and hypertension in patients with spinal canal anesthesia cause of low back pain, postoperative effect was statistically significant.Patients’ gender, age, type of surgery, blood loss and whether hypertension accept the occurrence of postoperative nausea and vomiting in patients with spinal canal anesthesia was statistically significant. Patients’ age, type of operation, operation time,whether suffering from infectious diseases, whether the bleeding, whether diabetes mellitus and hypertension accept the occurrence of postoperative complications in patients with spinal canal anesthesia effect was statistically significant.5. Spinal canal anesthesia complications of multiple factors analysis:dexamethasone dosing method, operation type, blood loss, whether combined with high blood pressure in patients with spinal canal, the influence of headache after anaesthesia is statistical significance. Whether dexamethasone delivery methods, age,blood loss, hypertension patients with anaesthesia intra-spinal canal the impact of lower back pain there is statistical significance. Dexamethasone delivery way, age,blood loss in patients with spinal canal, the influence of nausea and vomiting after anaesthesia there is statistical significance. Dexamethasone delivery way, age,operation time, blood loss, whether suffering from infectious diseases, and whether to merge the influence of high blood pressure patients with complications after anaesthesia intra-spinal canal there is statistical significance(p < 0.05). The use of dexamethasone is the independent impact factors of complications after spinal canal anesthesia.Conclusion:The using of dexamethasone is an independent protection factor of the happening of the common complications after spinal canal anesthesia. Whether intravenous dexamethasone or spinal canal, spinal canal anesthesia complications can be cut down obviously. The spinal canal method, reduce the effect of spinal canal anesthesia complications is better.