Cai Ping, Zhou Chen-Xi, Li Dong, Chen Yin-Lei, Chang Zhi-Yong, Xie Lin
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, Jiangsu Province.
Zhongguo Zhen Jiu. 2020 Dec 12;40(12):1309-13. doi: 10.13703/j.0255-2930.20200305-k0005.
To evaluate the analgesic effect and application advantage of acupuncture combined with local anesthesia of lidocaine in percutaneous vertebroplasty (PVP) for the patients with osteoporotic vertebral compression fracture (OVCF).
A total of 60 patients with OVCF and receiving PVP at single vertebra under local anesthesia were selected and randomized into an acupuncture plus medication group and a simple medication group, 30 cases in each one. In the simple medication group, the local laying infiltration anesthesia with 1% lidocaine 30 mL was used. In the acupuncture plus medication group, firstly, filiform needles were used to stimulate Hegu (LI 4), Neiguan (PC 6), Jinmen (BL 63) and Yintang (GV 29) with reducing technique, and then the epidermal infiltration anesthesia was followed with 1% lidocaine 4 mL. The needles were retained till the end of operation. Successively, before operation (T), during skin incision (T), at the time of working channel completion (T) and at the time of the injection of bone cement by half a dose (T), as well as at the end of operation (T), the mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO) and numerical rating scale (NRS) score were recorded. Besides, the key time of operation and adverse reactions during the operation were recorded, as well as the hospital stays after operation and the subjective satisfaction of the patients.
In the acupuncture plus medication group, MAP and HR were lower than those in the simple medication group at T, T and T respectively (<0.05). NRS scores in the acupuncture plus medication group were lower than the simple medication group at T and T respectively (<0.05). The key time of operation in the acupuncture plus medication group was shorter than the simple medication group (<0.05). The incidence of adverse reaction in the acupuncture plus medication group was lower than the simple medication group (<0.05) and the excellence rate of subjective satisfaction was higher than the simple medication group (<0.05).
Acupuncture combined with medication reduces the dose and adverse reactions of anesthetics, alleviates pain degree of patients, shortens the duration of operation and improves patients' subjective satisfaction in PVP for OVCF.
评估针刺联合利多卡因局部麻醉在经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)患者中的镇痛效果及应用优势。
选取60例行单节段椎体PVP的OVCF患者,随机分为针刺加药物组和单纯药物组,每组30例。单纯药物组采用1%利多卡因30 mL局部浸润麻醉。针刺加药物组先以毫针泻法针刺合谷(LI 4)、内关(PC 6)、金门(BL 63)和印堂(GV 29),再用1%利多卡因4 mL行表皮浸润麻醉,留针至手术结束。依次记录术前(T0)、皮肤切开时(T1)、工作通道建立完成时(T2)、骨水泥注射至半量时(T3)及手术结束时(T4)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO₂)和数字疼痛评分量表(NRS)评分。此外,记录手术关键时间及术中不良反应,以及术后住院时间和患者主观满意度。
针刺加药物组在T1、T2和T3时的MAP和HR分别低于单纯药物组(P<0.05)。针刺加药物组在T3和T4时的NRS评分分别低于单纯药物组(P<0.05)。针刺加药物组的手术关键时间短于单纯药物组(P<0.05)。针刺加药物组的不良反应发生率低于单纯药物组(P<0.05),主观满意度优良率高于单纯药物组(P<0.05)。
针刺联合药物可减少麻醉药物用量及不良反应,减轻患者疼痛程度,缩短手术时间,提高OVCF患者PVP治疗的主观满意度。