Abstract
Purpose To explore the effect of different anesthesia methods on emergence agitation (EA) and related complications in postoperative patients with osteosarcoma. Methods According to the order of admission, 115 patients requiring osteosarcoma surgery treated in our hospital from January 2018 to December 2020 were selected as the research object and randomly divided into the control group (n = 57, accepted the general anesthesia with tracheal intubation) and the experimental group (n = 58, accepted the combined spinal-epidural anesthesia) to compare their anesthesia effect, incidence rates of agitation and complications, and other indexes. Results In terms of the hemodynamic indexes (MAP, HR, and CVP values), both groups had lower ones at T1 than at T0, but the decline of the experimental group was generally lesser than that of the control group; at T2, no statistical difference was shown within the experimental group's indexes when comparing with those at T1, but the control group obtained a significant increase; at T3 and T4, both groups had their hemodynamic indexes increased, but such increase within the experimental group showed no statistical difference when comparing with those at T0, while the control group achieved obviously higher values at T4 than at T0 (before the anesthesia); and the between-group difference in the hemodynamic indexes at T1 and T4 was significant. Compared with the control group, the experimental group achieved better VAS scores and anesthesia indexes and lower incidence rates of EA and complications such as the hypoxemia, cardiovascular response, delayed recovery, and headache. In addition, the differences in the incidence rates of hypotension and cognitive dysfunction between the two groups were not statistically significant. Conclusion When comparing with tracheal intubation general anesthesia, the combined spinal-epidural anesthesia has a better effect in osteosarcoma surgery, with less hemodynamics influence on patients, reduced postoperative pain and stress reaction, and lowered incidence rates of postoperative EA and complications, which is worthy of wide application in clinical treatment.
Highlights
Osteosarcoma is a malignant bone tumor that involves the cortical bone, marrow cavity, and periosteum and usually occurs in proximal tibia, proximal humerus, and metaphysis of the distal femur by the way of directly producing osteoid tissue with tumor cells
General Information. 115 patients with the need of osteosarcoma surgery treated in our hospital from January 2018 to December 2020 were selected as the research object and randomly divided into the control group (n 57) and the experimental group (n 58) according to the order of admission. e comparison result of the baseline information of patients between the two groups showed no statistical significance (P > 0.05) and no influence on the study of between-group difference (Table 1)
Inclusion Criteria. e inclusion criteria were as follows: patients met the relevant indicators of osteosarcoma surgery; the American Society of Anesthesiologists (ASA) grades were I–III; patients had no history of relevant drug allergies; patients had no mental or other cognitive impairment; and the study was approved by the hospital ethics committee, and patients’ family members signed the informed consent
Summary
Osteosarcoma is a malignant bone tumor that involves the cortical bone, marrow cavity, and periosteum and usually occurs in proximal tibia, proximal humerus, and metaphysis of the distal femur by the way of directly producing osteoid tissue with tumor cells. It is often presented as grayish-red or brownish-red spindle-shaped tumor with fish-like lesion section [1–4]. Combined spinal-epidural anesthesia is an emerging anesthesia modality in recent years, which has advantages such as the fast onset and good blocking effect It ensures prolonged surgical anesthesia, which meets the demand of osteosarcoma surgery, but there are few related studies currently. To solve the problem fundamentally, the effect of different anesthesia methods on EA and related complications in postoperative patients with osteosarcoma was explored, and the summary results are as follows
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