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韩振川,毛克亚,王博,熊森,张雅斌,刘建恒.微创经椎间孔腰椎椎体间融合术后切口注射罗哌卡因的镇痛效果[J].脊柱外科杂志,2016,14(2):79-82.
微创经椎间孔腰椎椎体间融合术后切口注射罗哌卡因的镇痛效果     点此下载全文 (Fulltext)
韩振川  毛克亚  王博  熊森  张雅斌  刘建恒
解放军总医院骨科, 北京 100853
基金项目:
DOI:10.3969/j.issn.1672-2957.2016.02.004
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摘要:
      目的 观察罗哌卡因用于微创经椎间孔腰椎椎体间融合术(MI-TLIF)术后镇痛的临床效果。方法 2013年1月-2014年6月,在本院采用MI-TLIF治疗的单节段腰椎椎间盘突出症患者90例,随机分为罗哌卡因组(A组)和患者自控镇痛组(B组),研究过程遵循双盲对照原则。A组患者术后在切口周围环形全层给予1%罗哌卡因注射100.00 mg(生理盐水稀释至20.00 mL)。B组患者术后给予舒芬太尼患者自控镇痛(PCA)。术后(2 h、6 h、12 h、24 h)对患者进行疼痛视觉模拟量表(VAS)评分、镇痛满意度、镇痛补救情况及不良反应发生情况评价。结果 2组患者一般资料比较差异无统计学意义(P>0.05)。A组术后2 h、6 h VAS评分低于B组,差异具有统计学意义(P<0.05);术后12 h、24 h 2组间差异无统计学意义(P>0.05)。A组术后有1例患者进行了镇痛补救,B组术后有4例患者进行了镇痛补救。A组(77.8%)术后镇痛满意率明显优于B组(60.0%),差异有统计学意义(P<0.05)。A组和B组不良反应发生率分别为17.8%和44.4%,差异有统计学意义(P<0.05)。结论 MI-TLIF术后切口周围局部注射罗哌卡因较PCA效果更确切,可明显减轻患者术后急性疼痛,增加患者术后镇痛满意度。
关键词:腰椎  椎间盘移位  脊柱融合术  外科手术,微创性  疼痛,手术后  酰胺类  镇痛  麻醉
Analgesic effect of incisional injection of ropivacaine after minimally invasive transforaminal lumbar interbody fusion    Fulltext
HAN Zhen-chuan  MAO Ke-ya  WANG Bo  XIONG Sen  ZHANG Ya-bin  LIU Jian-heng
Department of Orthopaedics, General Hospital of PLA, Beijing 100853, China
Fund Project:
Abstract:
      Objective To observe the postoperative analgesia effects of ropivacaine after minimally invasive transforaminal lumbar interbody fusion(MI-TLIF). Methods From January 2013 to June 2014,90 patients undergoing single segmental lumbar disc herniation surgery were randomly divided into the ropivacaine group(group A) and patient controlled analgesia(PCA) group(group B). Group A received 1% ropivacaine 100.00 mg by subcutaneous injection(diluted with saline to 20.00 mL) around the incision,and group B sufentanil for PCA after MI-TLIF surgery. All the patients underwent visual analogue scale(VAS),satisfaction evaluation after analgesia,rescue pain medication and adverse effect evaluation after surgery(2,6,12 and 24 h). Results There was no significant difference in general information between the 2 groups(P>0.05). VAS scores at 2 and 6 h post-operation were lower in group A than in group B,and the difference was statistically significant(P<0.05). There were no significant differences in 12 h- and 24 h- VAS scores between the 2 groups(P>0.05). One patient underwent postoperative analgesia rescue in group A,and 4 patients did the same treatment in group B. The postoperative analgesia satisfaction rate was significantly better in group A(77.8%) than in group B(60.0%),and the difference was statistically significant(P<0.05). There was significant difference in the incidence of adverse reaction between the 2 groups(17.8% vs. 44.4%,P<0.05). Conclusion Ropivacaine can effectively reduce incisional pain of patients after MI-TLIF,and increase postoperative analgesia satisfaction.
Keywords:Lumbar vertebrae  Intervertebral disc displacement  Spinal fusion  Surgical procedures,minimally invasive  Pain,postoperative  Amides  Analgesia  Anesthesia
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