Conscious Sedation And Analgesia With Drug Combination In Lumbar Radiofrequency Thermal Coagulation Combined Ozone Arthrodesis

Purpose:To discuss the technique of Radiofrequency thermocoagulation(RFTC) unite Ozone fusion for Intervertebral Disc. Implement remifentanil and propofol for basic drug combination to conscious sedation and analgesia.And to research this method’s effect on hemodynamics and stress reaction. Analysis of the method of conscious sedation and analgesia for this kind of surgery.Methods:Divide120patients (ASA Ⅲ～Ⅳ) who have operation for Intervertebral Disc into four equal groups(n=30), Physiological saline group (group Ⅰ),Remifentanil group (group Ⅱ),Propofol-Remifentanil group(group Ⅲ), Propofol-Remifentanil-Esmolol group (group Ⅳ).Monitoring PetCO2when the patients get into the operating room. Continually and respectively injected physiological saline, remifentunil, propofol-remifentanil, profofol-remifentanil-esmolol, the injection speed is respective lmg.kg-1,0.5ug.kg-l.min-1,50ug.kg-l.min-1.During the process of puncture,needle injecting and infiltration anesthesia should be commencing at the same time. Record each time’s HR,SBP,RPP, Remesay,VAS scores,SPO2,PetCO2on the time point of preoperative(To),needle into the intervertebral disc(T1), radiofrequency when the temperature is95℃(T2), Ozone fusion(T3).The doses and pump speeds of esmolol,remifentanil,propofol,and inquire the improvement situation of waist and leg’s discomfort. Outcome:There is no difference among age, weight, highlight segments, VAS score of the fourth group at the statistics meaning (p>0.5). the index of SpO2、PetCO2during operation are both keep at permissive domain, and there is no difference before and after the surgery on the test of thumb, ankle joint, muscle strength of little toe, which can follow instructions without excessive equanimity. The scores of SBP、HR、RPP、 VAS at T1、T2、T3Of Group I are all higher than those at TO with obvious statistical meaning(P<0.05). The scores of HR and RPP of group II are higher than those at TO, but without statistical meaning. However, the score of VAS and RSS of group Ⅲ, Ⅳ are lower than before(p<0.05). the score of SBP, HR, RPP,VAS, RSS at T1、T2、T3Of Group are lower (p<0.05). comparing group III, HR at T1,T2,T3is lower (P<0.05). the RPP of group Ⅳ is lower at T2,T3(p<0.05).Conclusions:To use remifentanil and propofol for basic drug to conscious sedation and analgesia on the technique of Radiofrequency thermocoagulation unite Ozone fusion for Intervertebral disc could alleviate patients’ pain,reduce their adverse stress reactions, stabilize the hemodynamics, protect the safety of patients. In this kind of surgery, drug combination to conscious sedation and analgesia is a preferable anesthetic method.