Wu Jiang-Lin, Su Hai-Tao, Liang Yi-Hao, Peng Jia-Jie, Hong Wei-Wu
Department of Orthopedics, Second Affiliated Hospital of Guangzhou University of CM, Guangzhou 510000, Guangdong Province, China.
Zhongguo Zhen Jiu. 2020 Feb 12;40(2):147-51. doi: 10.13703/j.0255-2930.20190125-k00034.
To observe the auxiliary analgesic effect of wrist-ankle acupuncture on patients undergoing transforaminal endoscope surgery.
A total of 64 patients with lumbar disc herniation who underwent percutaneous lateral transforaminal endoscope surgery were randomly divided into an observation group and a control group, 32 cases in each group. The patients in the control group were treated with injection of 1% lidocaine for routine local infiltration anesthesia. The patients in the observation group were treated with wrist-ankle acupuncture at lower 5 area and lower 6 area for 30 min, 5 min before routine local infiltration anesthesia; immediately, 15 min, 30 min after insertion the left-right technique, up-down technique, and rotation technique were applied for six times, respectively. The mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO) and pain visual analogue scale (VAS) were compared between the two groups at the time points of intraoperative puncture (T), circular saw grinding (T), and placement of working channel (T). The intention of reoperation was recorded immediately after operation and 24 h after operation. The expectation and treatment credibility scale (ETCS) was used to evaluate the relationship between patients' expectation and efficacy 5 min before operation and immediately after operation.
At T and T during the operation, the MAP and HR in the obserrvation group were lower than those in the control group, while SpO was higher than that in the control group (<0.05). At T, there was no significant difference of MAP, HR and SpO between the two groups (>0.05). At T, the peak VAS and average VAS in the observation group were lower than those in the control group (<0.05), but there was no significant difference at T and T (>0.05). The intention of reoperation in the observation group was higher than that in the control group both immediately after operation and 24 h after operation (<0.05). In the observation group, the scores of each item in ETCS immediately after operation were higher than those 5 min before operation (<0.05), while in the control group there was no significant difference between immediately after operation and 5 min before operation (>0.05). The scores of ETCS1, ETCS2 and ETCS3 immediately after operation in the observation group were higher than those in the control group (<0.05).
The wrist-ankle acupuncture has positive auxiliary analgesic effect on lumbago during transforaminal endoscope surgery, and strengthens the patients' confidence on the operation effect.
观察腕踝针在经椎间孔镜手术患者中的辅助镇痛效果。
选取64例行经皮侧路椎间孔镜手术的腰椎间盘突出症患者,随机分为观察组和对照组,每组32例。对照组患者采用1%利多卡因注射液行常规局部浸润麻醉。观察组患者在常规局部浸润麻醉前5分钟,于腕踝针下5区、下6区行腕踝针治疗30分钟;进针后即刻、15分钟、30分钟分别应用左右捻转法、上下提插法、回旋法行针6次。比较两组患者在术中穿刺时(T)、环锯打磨时(T)、工作通道置入时(T)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO)及疼痛视觉模拟评分(VAS)。术后即刻及术后24小时记录再次手术意愿。采用期望与治疗可信度量表(ETCS)评估患者术前5分钟及术后即刻的期望与疗效的关系。
术中T、T时,观察组MAP、HR低于对照组,SpO高于对照组(P<0.05)。T时,两组MAP、HR、SpO比较差异无统计学意义(P>0.05)。T时,观察组VAS峰值及平均VAS低于对照组(P<0.05),T、T时比较差异无统计学意义(P>0.05)。术后即刻及术后24小时,观察组再次手术意愿高于对照组(P<0.05)。观察组术后即刻ETCS各项目评分高于术前5分钟(P<0.05),对照组术后即刻与术前5分钟比较差异无统计学意义(P>0.05)。观察组术后即刻ETCS1、ETCS2、ETCS3评分高于对照组(P<0.05)。
腕踝针在经椎间孔镜手术治疗腰痛中具有积极的辅助镇痛作用,并增强了患者对手术效果的信心。