Effect of goal-directed fluid therapy combined with erector spinae plane block on stress response and post-operative recovery after robot-assisted spine surgery
10.3969/j.issn.1006-5725.2025.21.013
- VernacularTitle:目标导向液体治疗联合竖脊肌平面阻滞对机器人辅助脊柱手术患者应激反应及术后恢复的影响
- Author:
Dandan HU
1
;
Ying DING
;
Jie CHEN
;
Qi WU
Author Information
1. 淮安八十二医院麻醉科(江苏淮安 223000)
- Publication Type:Journal Article
- Keywords:
orthopedic robot;
goal-directed fluid therapy;
erector spinae plane block;
stress response;
enhanced recovery after surgery
- From:
The Journal of Practical Medicine
2025;41(21):3385-3391
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of goal-directed fluid therapy(GDFT)combined with ultrasound-guided erector spinae plane block(ESPB)on perioperative stress response and postoperative recovery in patients undergoing robot-assisted pedicle screw fixation surgery.Methods Eighty patients scheduled for elec-tive surgery were randomly divided into two groups:control(general anesthesia+conventional fluid management,n=40)and intervention(general anesthesia+GDFT+ESPB,n=40).Heart rate(HR),mean arterial pressure(MAP),serum cortisol(Cor),norepinephrine(NE),blood glucose(GLU)levels,and resting VAS scores were measured and compared between the two groups preoperatively(T?),at screw placement(T?),at end of surgery(T?),30 minutes after extubation(T?),at 24 hours(T?),and 48 hours(T?)postoperatively.Intraoperative fluid volume,remifentanil consumption,postoperative rescue analgesia frequency,time to first ambulation,length of stay,and complications(agitation,nausea and vomiting,respiratory depression)were recorded.Results There were no differences in baseline(T?)indicators between the two groups(P>0.05).The intervention group exhibited significantly lower levels of HR,MAP,Cor,NE,and GLU at T?,T?,and T? compared with the control group(P<0.05),with Cor,NE,and GLU reduced by>30%at T?(P<0.05).Intraoperative fluid volume and remi-fentanil dosage were significantly reduced(both P<0.05).VAS scores and the number of rescue analgesia requests were lower at T?,T?,and T?(P<0.01).Time to first ambulation time and postoperative hospital stay were shortened(both P<0.01).The incidence of agitation,nausea/vomiting and overall complications was lower in the interven-tion group(P<0.05),whereas respiratory depression rates did not differ(P>0.05).Conclusion GDFT plus ESPB can effectively suppress perioperative stress response in robot-assisted spinal surgery,significantly reduce intraoperative opioid dosage and fluid volume,optimize postoperative analgesia,enhance recovery,and lower complication risk.This combination provides an effective ERAS strategy for improving surgical safety and recovery quality.
