Xu Tiantong, Tian Rong, Qiao Pan, Han Zhihua, Shen Qingfeng, Jia Yutao
Department of Spinal Surgery, Tianjin Union Medical Center, Tianjin, PR. China.
J Int Med Res. 2019 Mar;47(3):1146-1153. doi: 10.1177/0300060518817218. Epub 2019 Jan 11.
This study aimed to compare intraoperative lower back pain and leg pain, surgical time, and intraoperative X-ray dose in patients offered local infiltration anesthesia or continuous epidural anesthesia for transforaminal endoscopic spine system (TESSYS) surgery.
A total of 98 patients who received TESSYS treatment for single-segmental lumbar disc herniation were included, and were randomly divided into two groups: group A (49 cases; local infiltration anesthesia) and group B (49 cases; continuous epidural anesthesia). Surgical duration, intraoperative X-ray dose, and visual analog scale (VAS) scores of lower back pain and leg pain before surgery, during surgery, and 48 h after surgery were recorded and compared.
After surgery, the VAS scores of both lower back pain and leg pain decreased in group A, and similar findings were found in group B. Group B had a shorter surgical duration, lower intraoperative X-ray dose, and lower intraoperative VAS scores of lower back pain and leg pain compared with group A.
Compared with local infiltration anesthesia, continuous epidural anesthesia was more effective for pain relief during TESSYS for single-segmental lumbar disc herniation, and also contributed to a shorter surgical duration and lower X-ray exposure.
本研究旨在比较接受局部浸润麻醉或连续硬膜外麻醉的患者在经椎间孔内镜脊柱系统（TESSYS）手术中的术中下背痛和腿痛、手术时间以及术中X线剂量。
纳入98例接受TESSYS治疗单节段腰椎间盘突出症的患者，并随机分为两组：A组（49例；局部浸润麻醉）和B组（49例；连续硬膜外麻醉）。记录并比较手术时长、术中X线剂量以及术前、术中及术后48小时的下背痛和腿痛视觉模拟评分（VAS）。
术后，A组下背痛和腿痛的VAS评分均降低，B组也有类似结果。与A组相比，B组手术时长更短，术中X线剂量更低，术中下背痛和腿痛的VAS评分也更低。
与局部浸润麻醉相比，连续硬膜外麻醉在单节段腰椎间盘突出症的TESSYS手术中止痛效果更佳，还能缩短手术时长并减少X线暴露。
