预防性尾麻治疗腰椎间盘切除术后背痛:一项随机对照研究。

Hidayet S Cine, Ece Uysal
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摘要

目的:在这项随机前瞻性研究中,我们旨在通过尾侧超前镇痛缓解腰椎间盘手术后早期的手术和肌肉相关疼痛。材料与方法:本研究共纳入120例单节段腰椎间盘突出症患者。所有患者在手术前20min进行硬膜外尾侧注射。患者被分为三组。记录了非甾体抗炎药或曲马多的使用情况。术前和术后疼痛通过视觉模拟量表进行解释。结果:两组之间的所有术后测量结果均存在差异(p<0.05),第一组和第三组之间以及第二组和第3组之间存在差异。在第1小时、第2小时、第4小时和第24小时,两组之间的差异具有统计学意义(p<0.05)。第1组和第2组患者在第24小时和第1周的疼痛强度之间的差异有统计学意义(p>0.05)。对药物治疗效果的评估降低了背痛和脚痛的严重程度。结论:布比卡因或联合甲基强的松龙尾侧注射治疗腰椎间盘突出症是一种有效、安全的方法,可减轻术后疼痛,提高功能。
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Preemptive caudal anesthesia on back pain after lumbar discectomy: a randomized and controlled study.

Objective: In this randomized and prospective research, we aimed to relieve surgical and muscle-related pain early after lumbar disc operations with caudal preemptive analgesia.

Materials and methods: A total of 120 patients with single-level lumbar disc herniation were included in this study. The caudal epidural injection was performed for all patients 20 min before surgery. The patients were divided into three groups. Non-steroidal anti-inflammatory drugs or tramadol use were recorded. Pre-operative and post-operative pain was interpreted through a visual analog scale.

Results: There was a difference between the groups in all post-operative measurements (p < 0.05), between Group 1 and Group 3, and between Group 2 and Group 3. A statistical significance has been achieved between the groups at the 1st h, 2nd h, 4th h, and 24th h (p < 0.05). The difference between the pain intensities of the patients at the 24th h and the 1st week was statistically significant in Groups 1 and 2 (p < 0.05). Evaluation of the effects of medical treatments reduced the severity of back pain and foot pain.

Conclusion: The preemptive bupivacaine or in combination with methylprednisolone caudal injection is an effective and safe method to reduce post-operative pain and ameliorate functional capacity for the treatment of lumbar disc herniation.

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