超声引导胸椎旁神经阻滞与局部麻醉用于骨质疏松性压缩性骨折经皮椎体后凸成形术的疗效和安全性。

Effectiveness and safety of ultrasound-guided thoracic paravertebral block versus local anesthesia for percutaneous kyphoplasty in patients with osteoporotic compression fracture.

机构信息

Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Department of Anesthesiology, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

J Back Musculoskelet Rehabil. 2022;35(6):1227-1235. doi: 10.3233/BMR-210131.

DOI:10.3233/BMR-210131

PMID:35599464

Abstract

BACKGROUND

Kyphoplasty for osteoporotic vertebral compression fractures (OVCF) is a short but painful intervention. Different anesthetic techniques have been proposed to control pain during kyphoplasty; however, all have limitations.

OBJECTIVE

To compare the effectiveness and safety of ultrasound-guided thoracic paravertebral block with local anesthesia for percutaneous kyphoplasty (PKP).

METHODS

In this prospective study, non-randomized patients with OVCF undergoing PKP received either ultrasound-guided thoracic paravertebral block (group P) or local anesthesia (group L). Perioperative pain, satisfaction with anesthesia, and complications were compared between the groups.

RESULTS

Mean intraoperative (T1-T4) perioperative visual analog scale (VAS) scores were significantly lower in group P than in group L (2 [1-3] vs. 3 [2-4], 2 [2-3] vs. 4 [2-4], 2 [2-3] vs. 5 [3-5], and 3 [2-3] vs. 5 [3-5], respectively; P< 0.05). Investigators' satisfaction scores, patients' anesthesia satisfaction scores, and anesthesia re-administration intention rate were significantly higher in group P than in group L (4 [3-5] vs. 3 [2-4], 2 [2-3] vs. 2 [1-3], 90.63% vs. 69.70%; P< 0.05). There was no significant intergroup difference in complications.

CONCLUSIONS

Ultrasound-guided thoracic paravertebral block has similar safety to and better effectiveness than local anesthesia in PKP.

摘要

背景

骨质疏松性椎体压缩性骨折（OVCF）的经皮椎体后凸成形术（PKP）是一种短暂但痛苦的干预措施。已经提出了不同的麻醉技术来控制PKP 期间的疼痛；然而，所有这些技术都有其局限性。

目的

比较超声引导下胸椎旁神经阻滞与局部麻醉用于经皮椎体后凸成形术（PKP）的有效性和安全性。

方法

在这项前瞻性研究中，接受 PKP 的 OVCF 患者接受了超声引导下胸椎旁神经阻滞（P 组）或局部麻醉（L 组）。比较两组患者围手术期疼痛、麻醉满意度和并发症。

结果

与 L 组相比，P 组患者术中（T1-T4）围手术期视觉模拟评分（VAS）明显较低（2 [1-3] vs. 3 [2-4]，2 [2-3] vs. 4 [2-4]，2 [2-3] vs. 5 [3-5]，和 3 [2-3] vs. 5 [3-5]；P<0.05）。P 组调查员满意度评分、患者麻醉满意度评分和麻醉再给药意愿率明显高于 L 组（4 [3-5] vs. 3 [2-4]，2 [2-3] vs. 2 [1-3]，90.63% vs. 69.70%；P<0.05）。两组并发症无明显差异。