B超引导下竖脊肌平面阻滞在腰椎间孔镜手术麻醉患者中的应用效果及对应激反应的影响研究  

Study on the Application Effect of B-ultrasound Guided Erector Spinae Plane Block in Anesthesia Patients for Lumbar Intervertebral Foramen Surgery and Its Effect on Stress Response

作　　者：朱冠楠 高景斌 黄道礼 庞晓丽[2] 肖庆华 陈志斌 ZHU Guannan;GAO Jingbin;HUANG Daoli;PANG Xiaoli;XIAO Qinghua;CHEN Zhibin(Shaoguan First People’s Hospital,Shaoguan 512000,China)

机构地区：[1]广东省韶关市第一人民医院,广东韶关512000 [2]韶关学院医学院 [3]广东省韶关市乳源瑶族自治县人民医院

出　　处：《中国医学创新》2020年第20期113-117,共5页Medical Innovation of China

基　　金：韶关市科技计划项目(2019sn018)。

摘　　要：目的:探讨B超引导下竖脊肌平面阻滞在腰椎间孔镜手术麻醉患者中的应用效果及对应激反应的影响.方法:选取2019年1-9月入住本院接受腰椎间孔镜手术的患者80例.根据随机数字表法将其分为对照组和研究组,各40例.对照组仅施以局部麻醉,研究组施以B超引导下竖脊肌平面阻滞和局部麻醉.比较两组各时间点平均动脉压、心率、肾上腺素、去甲肾上腺素水平及术后各时间点疼痛症状评分.结果:T0时刻,两组平均动脉压、心率水平比较,差异均无统计学意义(P>0.05);T1、T2、T3、T4时刻,研究组的平均动脉压、心率水平均低于对照组,差异均有统计学意义(P<0.05).切皮后5 min,两组肾上腺素、去甲肾上腺素水平比较,差异均无统计学意义(P>0.05);手术结束时、术后6 h和1 d,研究组肾上腺素、去甲肾上腺素水平均低于对照组,差异均有统计学意义(P<0.05).术后2、6、12 h,研究组疼痛症状评分均低于对照组,差异均有统计学意义(P<0.05).结论:对腰椎间孔镜手术麻醉患者施以B超引导下竖脊肌平面阻滞,效果确切,可在临床上进一步推广与应用.Objective:To investigate the application effect of B-ultrasound guided erector spinae plane block on anesthesia patients in lumbar intervertebral foramen surgery and its effect on stress response.Method:A total of 80 patients admitted to our hospital from January to September 2019 for lumbar intervertebral foramina surgery were selected.According to the random number table method,they were divided into control group and study group,40 cases in each group.The control group received only local anesthesia,the study group was treated with B-ultrasound guided erector spinae plane block and local anesthesia.The mean arterial pressure,heart rate,epinephrine and norepinephrine levels at each time point and pain symptom scores at each time point after operation were compared between the two groups.Result:At T0,the average arterial pressure and heart rate of the two groups were compared,the differences were not statistically significant(P>0.05).At T1,T2,T3,T4,the mean arterial pressure and heart rate of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).5 min after peeling,the levels of epinephrine and norepinephrine were compared between the two groups,the differences were not statistically significant(P>0.05).At the end of surgery,6 h and 1 d after surgery,the levels of epinephrine and norepinephrine in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).At 2,6 and 12 h after surgery,the pain symptom scores of the study group were all lower than those of the control group,with statistically significant differences(P<0.05).Conclusion:The effect of B-ultrasound guided erector spinae plane block in patients anestheted by lumbar intervertebral foramina surgery is definite,which can be further popularized and applied in clinic.

关 键 词：B超引导下竖脊肌平面阻滞 腰椎间孔镜手术麻醉 应激反应 VAS评分 

分 类 号：R614[医药卫生—麻醉学]