Yamada Keisuke, Matsumoto Yoshihisa, Kita Masaki, Yamamoto Ken, Kobayashi Takeshi, Takanaka Tsuyoshi
Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
J Anesth. 2004;18(4):292-5. doi: 10.1007/s00540-004-0252-6.
We reviewed long-term pain relief in four patients undergoing percutaneous vertebroplasty (PVP) for lumbar or back pain due to metastatic vertebral tumors. The patients received anesthesiological palliative care with analgesics until their death after PVP. Pain intensity, the presence or absence of recurrence of pain, changes in dosage of analgesics given before and after PVP, and complications associated with PVP were evaluated. A numerical rating scale (NRS) from 0 (no pain) to 10 (worst pain imaginable) was used to measure pain. The patients were three men and one woman (mean age, 58 years). PVP was performed in five vertebrae (one thoracic and four lumbar). The NRS scores on moving before PVP were 10, 8, 10, and 10. After PVP, NRS decreased to 0, 3, 5, and 0, respectively, within 72 h. No recurrence of pain in the treated area occurred until death in any of these patients. The dosages of analgesics given were decreased in two cases, but no changes were made in the other two cases. There were no complications associated with PVP. Percutaneous vertebro-plasty is a safe and effective treatment for long-time pain relief in patients with metastatic vertebral tumors.
我们回顾了4例因转移性椎体肿瘤导致腰背痛而接受经皮椎体成形术（PVP）患者的长期疼痛缓解情况。这些患者在PVP术后直至死亡期间均接受了麻醉性姑息治疗及镇痛药治疗。评估了疼痛强度、疼痛是否复发、PVP前后给予镇痛药剂量的变化以及与PVP相关的并发症。采用0（无疼痛）至10（想象中最剧烈的疼痛）的数字评分量表（NRS）来测量疼痛。患者为3名男性和1名女性（平均年龄58岁）。对5个椎体（1个胸椎和4个腰椎）实施了PVP。PVP术前活动时的NRS评分分别为10、8、10和10。PVP术后，72小时内NRS分别降至0、3、5和0。这些患者直至死亡，治疗部位均未出现疼痛复发。2例患者给予的镇痛药剂量减少，另外2例未发生变化。未出现与PVP相关的并发症。经皮椎体成形术是一种安全有效的治疗方法，可使转移性椎体肿瘤患者长期缓解疼痛。
