超声引导下双侧竖脊肌平面阻滞在内镜下经椎间孔腰椎椎体间融合术中的镇痛作用

Qiying Wang, Xiao-Lin Qian, J. Li
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摘要

目的探讨超声引导下双侧竖脊机脊柱平面阻滞(ESPB)对内镜下经椎间孔腰椎椎体间融合术(TLIF)患者的镇痛作用。方法选择2018年1月~ 2019年4月在河南省第三人民医院行TLIF的患者86例,按随机数字表法分为对照组和观察组,每组43例。对照组全麻,观察组在全麻基础上行超声引导下双侧ESPB。观察两组患者术后1小时、6小时、12小时、24小时、48小时休息、翻身时视觉模拟评分(VAS)、自我镇痛次数、补救镇痛次数及镇痛满意度。记录两组患者术后48 h内嗜睡、恶心、尿潴留、伤口感染、皮肤瘙痒等不良反应的发生情况。结果术后1小时、6小时、12小时、24小时观察组其余时间VAS评分均低于对照组,差异均有统计学意义(p < 0.05)。结论超声引导下双侧ESPB在内镜下TLIF中能起到良好的镇痛效果,减轻术后疼痛。关键词:镇痛;超声波;竖脊面块;经椎间孔腰椎椎间融合术;不良反应;满意度
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Analgesic effects of ultrasound-guided bilateral erector spinae plane block on patients undergoing endoscopic transforaminal lumbar interbody fusion
Objective To investigate the analgesic effects of ultrasound-guided bilateral erector spinae plane block (ESPB) on patients undergoing endoscopic transforaminal lumbar interbody fusion (TLIF). Methods Eighty-six patients who were going to have TLIF in the Third People’s Hospital of Henan Province from January 2018 to April 2019 were selected, and they were divided into control group and observation group according to random number table method, with 43 cases in each group. The control group received general anesthesia, while the observation group underwent ultrasound-guided bilateral ESPB on the basis of general anesthesia. On 1 hour, 6 hours, 12 hours, 24 hours and 48 hours after operation, visual analogue scale (VAS) scores during rest and overturning, times of self analgesia, times of remedial analgesia and satisfaction of analgesia of the two groups were observed. The incidence of adverse reactions of the two groups, such as drowsiness, nausea, urinary retention, wound infection, itchy skin, within 48 h after operation were recorded. Results At 1 hour, 6 hours, 12 hours, and 24 hours after surgery, the VAS scores during rest of the observation group were lower than those of the control group, allP 0.05). Conclusions Performing ultrasound-guided bilateral ESPB in endoscopic TLIF can provide good analgesic effects and alleviate postoperative pain. Key words: Analgesia; Ultrasound; Erector spinae plane block; Transforaminal lumbar interbody fusion; Adverse reactions; Satisfaction
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