曲安奈德复合镇痛液对硬膜外麻醉神经损伤后根性疼痛的治疗作用  

Effect of analgesic solution combined with triamcinolone on the prognosis of the nerve injury under epidural anesthesia

作　　者：余开锋[1] 冉然[1] 潘雪莲[1] 李颖波[1] 

机构地区：[1]十堰市人民医院麻醉科,湖北十堰442000

出　　处：《西部医学》2011年第1期110-111,共2页Medical Journal of West China

摘　　要：目的观察曲安奈德复合镇痛液对硬膜外麻醉神经损伤后根性疼痛的治疗作用，并对其治疗的安全性进行评估。方法选择60例需行硬膜外麻醉，并且均于穿刺或置管过程中因多次刺激神经根而反复出现放射性疼痛的患者，ASAⅠ～Ⅱ级，随机分为实验组（S）和对照组（D），每组30例，手术结束后，S组硬膜外腔立即推注曲安奈德20mg、0．8％利多卡因、vitBl 100mg、vitB12 500μg的曲安奈德复合镇痛液10ml，D组推注0．8％利多卡因、vitB1 100mg、vitB12 500μg镇痛液10ml。观察两组患者术后出现根性疼痛的概率，并对其疼痛进行VAS评分，对于VAS〉3分的患者术后每7天重复上述治疗一次，记录根性疼痛恢复的时间，并于术前及术后4天内观察两组患者的血糖水平。结果S组出现根性疼痛的概率、疼痛的强度明显低于D组（P〈0．01），恢复的时间明显短于D组（P〈0．01），血糖S组治疗时与术前相比均升高，但无统计学意义。结论硬膜外腔注射曲安奈德复合镇痛液能有效地预防和治疗硬膜外麻醉时神经损伤导致的根性疼痛，并对患者血糖没有明显影响，治疗安全有效。Objective To investigate the effect of the analgesic solution combined with triamcinolone on the prognosis of the nerve injury under epidural anesthesia and evaluate its security. Methods 60 patients ASA I-II grade suffered from the radiating pain because the nerve root was stimulated under epidural anesthesia were randomly allocated into two groups, group S （n=30） and group D {n=30）. In group S 10ml analgesic solution consisted of 0.8% lidocaine and triamcinolone 20rag plus vitB1 100mg and vitB12 500ug was infused after operation. In group D 10ml analgesic solution consisted of 0. 8% lidocaine plus vitB1 100mg and vitB12 500ug was infused after operation. The incidence of root pain and the visual analgesic score （ VAS 0-10 ） were recorded, when VAS〉3 the above treatment was repeated every 7 days until VAS〈3. Recovery time of root pain and blood glucose were measured in both groups. Results Compared with group D, the incidence of root pain and VAS in group S was significantly decreased. The recovery time in group S was significantly shortened. Compared with the preoperative BS, postoperative BS in group S was increased. But there was no statistic significance. Conclusion Epidural injection of the analgesic solution combined with triamcinolone was an effective and secure methods to prevent the root pain and promote the nerve repair after nerve injury.

关 键 词：曲安奈德 硬膜外 麻醉 神经损伤 

分 类 号：R614.42[医药卫生—麻醉学]