Xiang Jiangxia, Zhong Weiyang, Ou Yunsheng
Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Traumatology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China.
Front Surg. 2022 Mar 25;9:769102. doi: 10.3389/fsurg.2022.769102. eCollection 2022.
Although various studies have described the methods of administering anesthesia during percutaneous vertebroplasty (PV) for treating osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen. Therefore, this study aimed to investigate the effects of three application methods of local analgesia administration in PV for treating OVCFs.
A total of 96 patients with OVCFs were reviewed and divided into three groups (A: lidocaine, B: ropivacaine, C: lidocaine + ropivacaine). The visual analog scale (VAS), blood pressure (BP), heart rate (HR), blood oxygen saturation (BOS), and surgery time were recorded during the following different points: before puncture, during the puncture, cement injection, and 4-h after surgery.
The mean age of the patients was 74.13 ± 7.02 years in group A, 70.47 ± 5.50 years in group B, and 73.07 ± 7.51 years in group C, without significant difference. No significant differences were found in sex, age, hospital stay, surgery time, blood loss, and cement volume of the patients. In the periods of before puncture and 4-h after surgery, the VAS in group C decreased significantly than that in the periods of the puncture, cement injection, and immediately after surgery. Overall, there were no significant differences in systolic BP, diastolic BP, HR, and BOS during the different periods among the groups except HR in the period of the puncture in group C, which was slower than that in other groups, and HR in the period of cement injection in group A, which was faster than the other two groups. A correlation was observed between the VAS and the periods of cement injection ( = 0.5358) and after surgery ( = 0.5775) in group C.
Compared with the other two methods, the use of lidocaine in combination with ropivacaine could effectively relieve intraoperative pain, making the patients feel more comfortable and experience better recovery.
尽管多项研究描述了经皮椎体成形术（PV）治疗骨质疏松性椎体压缩骨折（OVCFs）时的麻醉给药方法，但对于最佳治疗方案仍未达成共识。因此，本研究旨在探讨局部镇痛三种给药方法在PV治疗OVCFs中的效果。
回顾性分析96例OVCFs患者，分为三组（A组：利多卡因；B组：罗哌卡因；C组：利多卡因+罗哌卡因）。在穿刺前、穿刺过程中、骨水泥注入时及术后4小时等不同时间点记录视觉模拟评分（VAS）、血压（BP）、心率（HR）、血氧饱和度（BOS）及手术时间。
A组患者平均年龄为74.13±7.02岁，B组为70.47±5.50岁，C组为73.07±7.51岁，差异无统计学意义。患者的性别、年龄、住院时间、手术时间、失血量及骨水泥用量差异均无统计学意义。在穿刺前及术后4小时，C组的VAS较穿刺时、骨水泥注入时及术后即刻明显降低。总体而言，除C组穿刺时HR慢于其他组，A组骨水泥注入时HR快于其他两组外，各组不同时期的收缩压、舒张压、HR及BOS差异均无统计学意义。C组VAS与骨水泥注入时（r=0.5358）及术后（r=0.5775）呈正相关。
与其他两种方法相比，利多卡因联合罗哌卡因能有效缓解术中疼痛，使患者感觉更舒适，恢复更好。
