| 黄鑫,蒋国强,王扬生,王福生.经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折术中使用椎体内局部麻醉的镇痛效果评价[J].脊柱外科杂志,2017,15(5):279-283. |
经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折术中使用椎体内局部麻醉的镇痛效果评价  点此下载全文 (Fulltext) |
| 黄鑫1 蒋国强2 王扬生1 王福生1 |
1. 宁波大学医学院附属鄞州医院骨科, 浙江 315040;
2. 宁波大学医学院附属医院骨科, 浙江 315020 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2017.05.005 |
| 摘要点击次数: 760 |
| 全文下载次数: 680 |
| 摘要： |
| 目的 观察经皮椎体后凸成形术（PKP）术中使用椎体内局部麻醉对患者术中、术后的镇痛效果，探讨减少骨质疏松性椎体压缩性骨折（OVCF）患者术中、术后疼痛，改善手术体验和满意度的方法。方法 选择2014年1月-2015年10月在宁波大学医学院附属鄞州医院骨科行PKP手术的84例OVCF患者的临床资料，随机分为空白组（A组）、利多卡因组（B组）、罗哌卡因组（C组），每组28例，在术中建立穿刺工作套管后B组及C组分别向椎体内注射1%盐酸利多卡因5 mL和1%盐酸罗哌卡因5 mL，A组不给药，记录术前、术中球囊扩张时、骨水泥注入时、术毕即刻、术后6 h、术后24 h患者的疼痛视觉模拟量表（VAS）评分，并进行统计学分析。术后评估患者对手术的满意度。结果 术前3组一般资料及VAS评分比较差异无统计学意义（P > 0.05）。术中、术后VAS评分进行两两比较，球囊扩张时和骨水泥注入时，B组、C组VAS评分均低于A组，差异具有统计学意义（P < 0.05）；术毕即刻VAS评分A组 > B组 > C组，且组间差异均具有统计学意义（P < 0.05）；术后6 h A组与B组间VAS评分差异无统计学意义（P > 0.05），C组评分仍低于另两组且差异均具有统计学意义（P < 0.05）。术后24 h 3组间VAS评分差异无统计学意义（P > 0.05）。术后调查3组患者对"再次手术"的接受程度，3组间差异无统计学意义（P > 0.05）。结论 PKP治疗OVCF，术中椎体内局部麻醉能有效缓解术中疼痛，改善患者手术体验，提高患者对手术的信任，且不影响手术临床效果。 |
| 关键词：老年人 胸椎 腰椎 骨质疏松 脊柱骨折 骨折,压缩性 经皮椎体后凸成形术 麻醉,局部 |
| Evaluation on analgesic effects of intraosseous anesthesia in percutaneous kyphoplasty for osteoporotic vertebral compression fracture Fulltext |
| HUANG Xin1 JIANG Guo-qiang2 WANG Yang-sheng1 WANG Fu-sheng1 |
1. Department of Orthopaedics, Yinzhou Hospital, Medical College of Ningbo University, Ningbo 315040, Zhejiang, China;
2. Department of Orthopaedics, Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China |
| Fund Project: |
| Abstract: |
| Objective To reduce the pain of the patients with osteoporotic vertebral compression fracture(OVCF) and improve their surgical experience by observing intraoperative and postoperative analgesic effects of intraosseous anesthesia in percutaneous kyphoplasty(PKP). Methods A total of 84 OVCF patients who were treated by PKP were selected from January 2014 to October 2015. The patients were randomly divided into the blank control group(group A),lidocaine group(group B) and ropivacaine group(group C). When the puncture channels were established in PKP,groups B and C were administrated with 5 mL of 1% lidocaine hydrochloride and 5 mL of ropivacaine hydrochloride,respectively,through intraosseous injection;while group A was not given any drugs. The visual analogue scale(VAS) scores were recorded as the observation indexes at the moment of pre-operation,intraoperative balloon expansion,injection of bone cement,immediately post-operation,postoperative 6 h,and postoperative 24 h. Patients' satisfaction on analgesic effects was evaluated after the operation. Results There were no significant differences between the 3 groups in preoperative general information and VAS score(P > 0.05). Pair-wise comparison was carried out for intraoperative and postoperative VAS scores. VAS scores in group B and C were lower than that in group A at the moment of balloon expansion and injection of bone cement,and the differences were statistically significant(P < 0.05). VAS scores of immediately post-operation were group A > group B > group C,and the differences were statistically significant(P < 0.05). There was no statistical difference between group A and group B at postoperative 6 h in VAS scores(P > 0.05),but there were statistical differences between group C and the former 2 groups(P < 0.05). Scores of the 3 groups at postoperative 24 h showed no statistical difference(P > 0.05). After operation,the patients were investigated for the acceptance of reoperation,and there were no significant differences between the 3 groups. Conclusion During PKP for OVCF patients,intraosseous anesthesia can effectively relieve the patient's intraoperative pain,and improve their operation experience,and improve their surgical to the operation,and does not affect the clinical effects of the operation. |
| Keywords:Aged Thoracic vertebrae Lumbar vertebrae Osteoporosis Spinal fractures Fractures,compression Percutaneous kyphoplasty Anesthesia,local |
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