| 郑筱亭,王滨城,吕碧涛,颜跃全,陈庆辉,林银辉,赖诗宏,赖传浩,黄彬,林禄江.经皮椎体成形术治疗骨质疏松性椎体压缩性骨折术中采用椎旁神经阻滞的镇痛效果[J].脊柱外科杂志,2021,19(6):377-381. |
经皮椎体成形术治疗骨质疏松性椎体压缩性骨折术中采用椎旁神经阻滞的镇痛效果  点此下载全文 (Fulltext) |
| 郑筱亭1△ 王滨城1△ 吕碧涛2 颜跃全3* 陈庆辉1 林银辉3 赖诗宏3 赖传浩1 黄彬1 林禄江1 |
| 1.华侨大学附属德化医院骨科，德化 362500 ;2.海军军医大学长征医院骨科，上海 200003 ;3.华侨大学附属德化医院麻醉科，德化 362500 |
| 基金项目：福建中医药大学校管课题临床专项项目（XB2020145） |
| DOI：10.3969/j.issn.1672-2957.2021.06.004 |
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| 全文下载次数: 140 |
| 摘要： |
| 目的 探讨经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）术中采用椎旁神经阻滞的镇痛效果。方法 2020年1月-2020年8月，华侨大学附属德化医院采用PVP治疗OVCF患者60例，其中30例采用椎旁神经阻滞麻醉（神经阻滞组），30例采用传统局部麻醉（局部麻醉组）。比较2组手术时间、住院时间、住院总费用、术中平均动脉压和心率变化，及手术前后疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）。结果 2组手术时间、住院时间、住院总费用差异均无统计学意义（P>0.05）。神经阻滞组患者术中各时间点的平均动脉压、心率与术前比较，差异无统计学意义（P>0.05）；局部麻醉组患者术中各时间点的平均动脉压、心率均较术前升高，差异有统计学意义（P<0.05）。2组术后VAS评分、ODI均较术前明显降低，差异有统计学意义（P<0.05）；神经阻滞组术中、术后1 d、术后1个月VAS评分低于局部麻醉组，差异有统计学意义（P<0.05）；神经阻滞组术后1 d、术后1个月ODI低于局部麻醉组，差异有统计学意义（P<0.05）；2组术后3个月VAS评分、ODI差异无统计学意义（P>0.05）。结论 PVP治疗OVCF术中采用椎旁神经阻滞麻醉并未增加风险、手术时间及住院费用，术中血流动力学相对稳定，且可有效缓解患者术中、术后早期疼痛，值得临床推广应用。 |
| 关键词：胸椎 腰椎 骨折，压缩性 骨质疏松 椎体成形术 麻醉，传导 |
| Analgesic effect of paravertebral block in percutaneous vertebroplasty for osteoporotic vertebral compression fracture Fulltext |
| Zheng Xiaoting1△ Wang Bincheng1△ Lü Bitao2 Yan Yuequan3* Chen Qinghui1 Lin Yinhui3 Lai Shihong3 Lai Chuanhao1 Huang Bin1 Lin Lujiang1 |
| 1. Department of Orthopaedics，Dehua Hospital of Huaqiao University，Dehua 362500，Fujian，China ;2. Department of Orthopaedics，Changzheng Hospital，Navy Medical University，Shanghai 200003，China ;3. Department of Anesthesiology，Dehua Hospital of Huaqiao University，Dehua 362500，Fujian，China |
| Fund Project: |
| Abstract: |
| Objective To investigate the analgesic effect of paravertebral block in percutaneous vertebroplasty(PVP) for the treatment of osteoportic vertebral compression fracture(OVCF). Methods From January 2020 to August 2020,60 OVCF patients were treated by PVP in Dehua Hospital of Huaqiao University. Among them,30 patients were treated with paravertebral block anesthesia(block group) and 30 with traditional local anesthesia(local group). The operation time,hospital stay,hospitalization cost,intraoperative mean arterial pressure(MAP) and heart rate(HR),pre- and post-operative visual analogue scale(VAS) score and Oswestry disability index(ODI) were compared between the 2 groups. Results There was no significant difference in operation time,hospital stay and hospitalization cost between the 2 groups(P>0.05). In the block group,there was no significant difference in intraoperative MAP and HR at each time point compared with those at pre-operation(P>0.05). In the local group,the MAP and HR were higher than those at pre-operation,and the differences were statistically significant(P<0.05). The VAS score and ODI of the 2 groups were significantly reduced compared with those at pre-operation,all with a statistical difference(P<0.05). The VAS scores at intra-operation,postoperative 1 d and postoperative 1 month in the block group were significantly lower than those in the local group(P<0.05). The ODI at postoperative 1 d and postoperative 1 month in the block group were significantly lower than those in the local group(P<0.05). There was no significant difference in VAS score and ODI at postoperative 3 months between the 2 groups(P>0.05). Conclusion PVP in the treatment of OVCF with paravertebral block anesthesia does not increase the risk,operation time or hospitalization cost,and intraoperative hemodynamics is relatively stable,and can effectively relieve the patients' intraoperative and early postoperative pain,which is worthy of clinical application. |
| Keywords:Thoracic vertebrae Lumbar vertebrae Fractures,compression Osteoporosis Vertebroplasty Anesthesia,conduction |
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