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经皮椎体后凸成形术中骨内麻醉的临床观察。

Clinical Observation of Intraosseous Anesthesia in Percutaneous Kyphoplasty.

机构信息

The Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Chengdu 610000, China.

Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu 610000, China.

出版信息

J Healthc Eng. 2021 Jun 1;2021:5528073. doi: 10.1155/2021/5528073. eCollection 2021.

Abstract

OBJECTIVE

Percutaneous kyphoplasty (PKP) is an effective minimally invasive technique in spine surgery in recent years. General anesthesia and local anesthesia are the main ways of anesthesia in PKP, and epidural anesthesia is also applied to PKP to some extent. However, all these three anesthetic methods have their respective advantages and disadvantages. It is essential to compare and evaluate the effects of different anesthesia methods on PKP for treating spinal fractures.

METHOD

A total of 45 patients (53 vertebral bodies were included) were divided into two groups. Group A included 24 patients (29 vertebral bodies) with an average of 71 years old and Group B included 21 patients (24 vertebral bodies) with an average of 74 years old. Visual analogue scale (VAS) scores were recorded preoperatively; balloon expansion and bone cement injection were conducted intraoperatively. Then, they were recorded immediately after operation, 6 h postoperatively, to assess the pain level of the patient. Moreover, hospitalization time (days), operation duration (minutes), and bone cement injection amount (mL) had also been recorded.

RESULTS

There was no significant difference in preoperative general information and VAS score. However, the VAS scores were statistically significant at both the moment of balloon expansion and injection of bone cement. At the moment of immediate postoperation, the VAS scores showed no statistically significant difference, while it showed a statistically significant difference 6 h postoperatively.

CONCLUSION

The anesthesia method by injection of 1% lidocaine hydrochloride (5 ml) into vertebral body can effectively relieve patients' pain in intraoperation and postoperation.

摘要

目的

经皮椎体后凸成形术(PKP)是近年来脊柱外科领域一种有效的微创技术。全身麻醉、局部麻醉是 PKP 中麻醉的主要方式,硬膜外麻醉在一定程度上也应用于 PKP,但这三种麻醉方法各有优缺点,比较和评价不同麻醉方法对治疗脊柱骨折的 PKP 的效果非常重要。

方法

共 45 例(53 个椎体)患者分为两组,A 组 24 例(29 个椎体),平均年龄 71 岁;B 组 21 例(24 个椎体),平均年龄 74 岁。术前记录视觉模拟评分(VAS);术中进行球囊扩张和骨水泥注射,术后即刻、术后 6 h 评估患者疼痛程度,并记录住院时间(天)、手术时间(分钟)、骨水泥注射量(mL)。

结果

两组患者术前一般资料及 VAS 评分差异无统计学意义,但球囊扩张及骨水泥注射时 VAS 评分差异有统计学意义,术后即刻 VAS 评分差异无统计学意义,术后 6 h 差异有统计学意义。

结论

在椎体内注射 1%盐酸利多卡因(5 ml)的麻醉方法可有效减轻患者术中及术后疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/496b/8189784/cc1cad90094f/JHE2021-5528073.001.jpg

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