椎弓根外侧浸润麻醉用于单侧穿刺椎体(后凸)成形术  

Application of extrapedicular infiltration anesthesia in unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty

作　　者：刘列华 王建刚 王晓嘉 吕应文 任周奎 于金华 刘旭 周强[3] LIU Lie-hua WANG Jian-gang WANG Xiao-jia LYU Ying-wen REN Zhou-kui YU Jin-hua LIU Xiu ZHOU Qiang(Department of Orthopedics, 13th People＇ s Hospital of Chongqing, Chongqing 400053, China Department of Radiology, 13th People＇ s Hospital of Chongqing, Chongqing 400053, China Orthopedics Center of PLA, Department of Orthopedics, Southwest Hospital, Third Military Medical University,Chongqing 400038, China)

机构地区：[1]重庆市第十三人民医院骨科,重庆400053 [2]重庆市第十三人民医院放射科,重庆400053 [3]第三军医大学西南医院骨科全军矫形外科中心,重庆400038

出　　处：《局解手术学杂志》2017年第3期178-180,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市卫生和计划生育委员会医学科研项目(2016MSXM084)

摘　　要：目的探讨椎弓根外侧浸润麻醉用于单侧穿刺椎体(后凸)成形术的麻醉效果。方法 2015年3月至2016年3月重庆市第十三人民医院20例患者接受1%利多卡因局部浸润麻醉加椎弓根外侧浸润麻醉后进行单侧穿刺椎体(后凸)成形术。评价患者术中穿刺时疼痛模拟评分(VAS)及是否需要增加芬太尼静脉麻醉,观察患者有无相应脊椎上位神经根的区域阻滞麻醉效应。结果患者穿刺时疼痛VAS评分为1~3分,平均(2.5±0.7)分,其中,2例1分,7例2分,11例3分。所有患者均没有申请芬太尼静脉麻醉,均无相应脊椎上位神经根的区域阻滞麻醉效应。结论椎弓根外侧1%利多卡因浸润麻醉可以满足经皮穿刺椎体成术形(PVP)和经皮椎体后凸成形术(PKP)手术单侧穿刺的需要,局部麻醉效果好,未见明显并发症。Objective To introduce extrapedicular infiltration anesthesia as an improved method of local anesthesia which applied to unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Methods From March 2015 to March 2016,20 patients in our hospital received percutaneous vertebroplasty or percutaneous kyphoplasty with 1% lidocaine local infiltration anesthesia and extrapedicular infil- tration anesthesia. The visual analogue score of patients during the operation and whether they needed additional sedative anesthesia were evaluated. The anaesthetic effect of nerve root block was observed. Results The visual analogue score of all the patients ranged from 1 point to 3 point, averagely （2.5±0.7 ） point. Among the 20 patients, there were 2 cases of 1 point, 7 cases of 2 point and 11 cases of 3 point. No patients required additional sedative anesthesia,and no nerve root block effects were observed. Conclusion Extrapedicular infiltration anesthesia provides good local anesthetic effects without significant complications, which deserved further use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

关 键 词：局部浸润麻醉 利多卡因 椎弓根单侧穿刺 椎体成形术 椎体后凸成形术 

分 类 号：R681.5[医药卫生—骨科学]