Kour Loveleen, Sharma Nandita, Dogra Disha
Department of Anaesthesia and Intensive Care, GMC, Jammu, Jammu and Kashmir, India.
Anesth Essays Res. 2021 Jan-Mar;15(1):119-125. doi: 10.4103/aer.aer_77_21. Epub 2021 Aug 30.
Traditional analgesics such as diclofenac and celecoxib have long been used in lumbosacral spine surgeries. Recently, preemptive single-shot caudal analgesia has been investigated by some workers with favorable results. We hypothesized that the thoracic route would not only allow preemptive but also postoperative analgesia through catheter insertion.
We aimed at studying the feasibility and efficacy of thoracic epidural analgesia (TEA) in lumbosacral spine surgeries.
This was a prospective, randomized, controlled study that comprised 60 American Society of Anesthesiologist (ASA) Physical Status I and II patients posted for lumbosacral spine surgeries.
Sixty ASA I and II patients were randomly divided into two groups: Group T - TEA was given using 0.2% ropivacaine 10 mL preemptive and postoperatively. Group C patients were given analgesia with intramuscular diclofenac 75 mg. Hemodynamic parameters, postoperative Visual Analog Scale scores, and neurological complications were noted.
Student's independent -test for comparing the continuous variables and Chi-square test for the categorical variables. Kruskal-Wallis test was used for postoperative pain data.
Duration and quality of analgesia were superior in Group T. There were more hemodynamic alterations in Group C but no neurological complication in any patient.
TEA proves to be an effective analgesic technique for lumbosacral spine surgeries.
传统镇痛药如双氯芬酸和塞来昔布长期用于腰骶部脊柱手术。最近，一些研究人员对单次预防性骶管镇痛进行了研究，结果良好。我们推测，经胸途径不仅可以实现预防性镇痛，还可以通过插入导管实现术后镇痛。
我们旨在研究胸段硬膜外镇痛（TEA）在腰骶部脊柱手术中的可行性和有效性。
这是一项前瞻性、随机、对照研究，纳入了60例拟行腰骶部脊柱手术的美国麻醉医师协会（ASA）身体状况I级和II级患者。
60例ASA I级和II级患者随机分为两组：T组——术前和术后均使用10 mL 0.2%罗哌卡因进行TEA。C组患者给予75 mg肌内注射双氯芬酸镇痛。记录血流动力学参数、术后视觉模拟量表评分和神经并发症。
采用学生独立t检验比较连续变量，采用卡方检验比较分类变量。采用Kruskal-Wallis检验分析术后疼痛数据。
T组镇痛持续时间和质量更佳。C组血流动力学改变更多，但所有患者均未出现神经并发症。
TEA被证明是腰骶部脊柱手术有效的镇痛技术。
