24. Đánh giá hiệu quả giảm tiêu thụ opioid của phương pháp gây tê ngoài màng cứng khi phối hợp với gây mê toàn thân qua theo dõi ANI trong phẫu thuật ổ bụng

Abstract

Epidural analgesia has become a wide spread anesthetic technique for the perioperative treatment of patients undergoing major abdominal surgery and is one of the sparing-opioid anesthetic strategies. This study evaluated the effectiveness of reducing opioid consumption of epidural anesthesia combined with general anesthesia through the ANI (Analgesia Nociception Index) in patient undergoing major abdominal surgery. 60 patients undergone major abdominal surgery with ASA I and II voluntarily participated in this study. The patients were divided into two groups: group 1 (n = 30) received combined epidural analgesia with general anesthesia and group 2 (n = 30) received general anesthesia. We evaluated the effectiveness of intraoperative opioid savings and the quality of recovery of combined epidural analgesia with general anesthesia through ANI monitoring in patient undergoing major abdominal surgery. There was insignificant difference in age, weight, ASA classification and surgical duration. The amount of fentanyl/kg, the number of fentanyl reminders, and the total ANI time < 50 of the 2 groups were statistically significant with p < 0.05. The time to extubation from the end of surgery, the rate of nausea and vomiting in the recovery period (2 hours after surgery) were not statistically significant with p > 0.05. The mean VAS score of the 2 groups was 6.83 ± 1.45 in group 1 and 4.33 ± 0.216, the difference was statistically significant with p < 0.005. In both groups, no case of postoperative respiratory failure was recorded. In conclusion, combined epidural analgesia with general anesthesia is effective in reducing intraoperative opioid consumption and has a better quality of perception and pain relief compared to general anesthesia.