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比较星状神经节阻滞治疗上肢带状疱疹后神经痛中利多卡因和罗哌卡因的效果。

Comparison of lidocaine and ropivacaine stellate ganglion blockade in treating upper limb postherpetic neuralgia.

机构信息

Department of Pain, Yichun People's Hospital, Yichun, Jiangxi Province, PR China.

Department of Pain, The Second Hospital of Dalian Medical University, Dalian, PR China.

出版信息

Medicine (Baltimore). 2022 Jun 10;101(23):e29394. doi: 10.1097/MD.0000000000029394.

Abstract

To provide a basis for treating postherpetic neuralgia (PHN), we compared the efficacy of lidocaine and ropivacaine stellate ganglion block (SGB) in PHN treatment in the upper limbs.Data from 252 patients with upper-limb PHN were retrospectively analyzed. The lidocaine group (n = 118) was treated with oral pregabalin capsules 75 mg twice a day, tramadol hydrochloride sustained release tablets 100 mg twice a day, and amitriptyline 25 mg once at night combined with ultrasound-guided lidocaine SGB; the ropivacaine group (n = 134) was orally administered the same medicines combined with ultrasound-guided ropivacaine SGB. The visual analog scale (VAS), self-rating anxiety scale (SAS), and adverse reactions were compared between the groups before treatment and at 1 week, 1 month, and 3 months after treatment.There were no significant differences between the lidocaine and ropivacaine groups in terms of sex, age, height, weight, and pain duration (P > .05). There was no significant difference between the groups in VAS and SAS scores before treatment (P > .05). At 1 week, 1 month, and 3 months after ultrasound-guided SGB treatment, the VAS and SAS scores were significantly lower in the ropivacaine group than in the lidocaine group (P < .05). There were no significant differences between the groups in terms of adverse reactions (P > .05).For ultrasound-guided SGB treatment of upper limb PHN, ropivacaine is superior to lidocaine. Ultrasound-guided ropivacaine SGB is safe and effective for the treatment of upper limb PHN.

摘要

为了为治疗疱疹后神经痛(PHN)提供依据,我们比较了利多卡因和罗哌卡因星状神经节阻滞(SGB)治疗上肢 PHN 的疗效。

回顾性分析了 252 例上肢 PHN 患者的数据。利多卡因组(n=118)接受口服普瑞巴林胶囊 75mg,每日 2 次,盐酸曲马多缓释片 100mg,每日 2 次,阿米替林 25mg,每晚 1 次,联合超声引导下利多卡因 SGB;罗哌卡因组(n=134)接受相同药物口服,联合超声引导下罗哌卡因 SGB。比较两组治疗前及治疗后 1 周、1 个月和 3 个月的视觉模拟评分(VAS)、焦虑自评量表(SAS)和不良反应。

利多卡因组和罗哌卡因组在性别、年龄、身高、体重和疼痛持续时间方面差异无统计学意义(P>.05)。治疗前两组 VAS 和 SAS 评分差异无统计学意义(P>.05)。超声引导 SGB 治疗后 1 周、1 个月和 3 个月,罗哌卡因组 VAS 和 SAS 评分均明显低于利多卡因组(P<.05)。两组不良反应差异无统计学意义(P>.05)。

对于超声引导 SGB 治疗上肢 PHN,罗哌卡因优于利多卡因。超声引导罗哌卡因 SGB 治疗上肢 PHN 安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50aa/9276270/224aa412f28d/medi-101-e29394-g001.jpg

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