Application Of Low Concentration Ropivacaine Combined With Sufentanil Spinal Anesthesia In Foraminal Endoscopic Surgery

Objective:To compare the anesthetic effect of Spinal Anesthesia by different doses of ropivacaine combined with sufentanil in percutaneous transforaminal endoscopic discectomy.Methods:75 patients with American Society of Anesthesiologist physical status Ⅰor Ⅱ,were selected for percutaneous transforaminal endoscopic discectomy,whose age range 25-65 years old,weight in 50～80kg,no limit on the gender.After obtaining Ethical Committee’s approval and patient’s consent,the patients were randomly divided into three groups(n=25),Group A(0.15%ropivacaine 7.5mg+sufentail 5ug,5ml in total),group B(0.20%ropivacaine 10.0mg +sufentail 5ug,5ml in total),and group C(0.25%ropivacaine 12.5mg +sufentail 5ug,5ml in total).All patients were treated with spinal anesthesia.Since the surgical position was lateral decubitus,the lateral decubitus position with spinal anesthesia in the same direction was selected according to the surgical position.Avoidance of the lesion segment and puncture with spinal anesthesia.After the cerebrospinal fluid was appeared,5ml of the configured drug was injected into the subarachnoid space,and the patient was asked to stretch his lower limbs and wait for the operation to begin in lateral decubitus.The following indicators were observed and recorded,the assessment of sensory nerve block,time to onset of sensory block,the highest level of pain block,the time required to reach the highest level of pain block,and the duration of anesthesia;Assessment of motor block: the onset time of motor block,recovery time of motor block and degree of motor block were recorded.Visual analogue scale(VAS)was used to evaluate the perioperative pain degree of the 3 groups,and the number of intravenous analgesic drugs was recorded.Results:The onset time of sensory block in group A was significantly different from that in group B and C(P<0.05),but there was no significant difference between group B and C(P>0.05).There was no significant difference in the maximum pain block time among the three groups(P>0.05).There were significant differences in the highest level of pain block,duration of anesthesia,onset time of motion block and recovery time of motion block(P<0.05).The pain degree of group A was significantly higher than that of group B and C(P<0.05),but there was no statistical difference between group B and C(P>0.05).There was no significant difference in the degree of motion block between group A and group B(P>0.05),and the degree of motion block between the two groups was significantly lighter than that of group C(P<0.05).Conclusion:Compared with different concentrations of ropivacaine combined with the same dose of sufentanil spinal anesthesia,the analgesic effect of 0.2%was satisfactory than that of 0.15%,and the degree of lower limb block was less than that of 0.25%,which was more suitable for percutaneous transforaminal endoscopic discectomy and had clinical application value.