0.5%利多卡因硬膜外自控镇痛对治疗带状疱疹后神经痛早期镇痛的效果分析  

Value analysis of analgesia effect about patient controlled epidural analgesia with 0.5%lidocaine for early postherpetic neuralgia

作　　者：颜铭[1] 刘东[1] 刘翔[1] 李京霞[1] 焦世华[1] 汤芹芹[1] 李远东[1] YAN Ming;LIU Dong;LIU Xiang;LI Jingxia;JIAO Shihua;TANG Qinqin;LI Yuandong(Pain Department,Chengdu Second People's Hospital,Sichuan,Chengdu 610015,China)

机构地区：[1]成都市第二人民医院疼痛科,四川成都610015

出　　处：《中国医药科学》2021年第12期54-57,共4页China Medicine And Pharmacy

摘　　要：目的探讨0.5%利多卡因硬膜外自控镇痛对治疗带状疱疹后神经痛早期镇痛效果分析。方法选取2015年5月至2018年3月就诊于成都市第二人民医院疼痛科的带状疱疹后神经痛患者90例,随机分成三组,利多卡因组(L组)、舒芬太尼组(S组)及利多卡因联用舒芬太尼组(C组),硬膜外自控镇痛1周后停药拔管,在治疗前、后分别评估镇痛效应、舒适质量、不良反应。结果三组患者性别、年龄、体重、病程比较,差异无统计学意义(P>0.05);三组治疗前(T_(0))、治疗后3 d(T_(1))、治疗后1个月(T_(2))相同时间点的疼痛视觉模拟评分(NRS)比较,差异无统计学意义(P>0.05),且三组T_(1)、T_(2)的NRS评分均低于治疗前,差异有统计学意义(P<0.05);三组简明疼痛评估量表(BPI)第9项中过去24 h内疼痛对日常生活、情绪、行走能力、日常工作、与人关系、睡眠及生活兴趣的影响比较,差异无统计学意义(P>0.05);三组治疗后1个月BPI第9项中过去24 h内疼痛对日常生活、情绪、行走能力、日常工作、与人关系、睡眠及生活兴趣的影响均低于治疗前,差异有统计学意义(P<0.05),三组间各时间点比较,差异无统计学意义(P>0.05)。三组不良反应总发生率比较,差异有统计学意义(P<0.05)。结论单独使用0.5%利多卡因硬膜外自控镇痛治疗躯干部带状疱疹后神经痛,与舒芬太尼及利多卡因联合舒芬太尼的用药镇痛效果相似,且减少不良反应的发生,有利于改善患者的早期舒适质量,是一种更为安全有效的治疗方式,值得临床选用。Objective To investigate the analysis of analgesia effect about patient controlled epidural analgesia(PCEA)with 0.5%lidocaine for early postherpetic neuralgia(PHN).Methods A total of 90 patients with PHN who were treated in the Pain Department of Chengdu Second People's Hospital from May 2015 to March 2018 were selected and randomly divided into 3 groups,namely,the lidocaine group(group L),the sufentanil group(group S)and the lidocaine combined with sufentanil group(group C).Patients received drug withdrawal and extubation one week after PCEA.The analgesic effect,comfort quality,and adverse reactions(ADRs)were evaluated before and after treatment.Results Comparison of differences in gender,age,weight,and course of disease among the three groups of patients showed no statistical significance(P>0.05).The NRS scores at the same time points of before treatme nt(T_(0)),3 days after treatment(T_(1))and 1 month after treatment(T_(2))were compared in three groups,and the data difference was not statistically significant(P>0.05).The NRS scores of the three groups at T_(1)and T_(2)were all lower than the pretreatment scores,with statistically significant differences(P<0.05).There was no statistically significant difference in the effects of pain during the past 24 hours on general activity,mood,walking ability,normal work,relations with other people,sleep and enjoyment of life(i.e.Item 9 of BPI)in three groups(P>0.05).The effects of pain during the past 24 hours on general activity,mood,walking ability,normal work,relations with other people,sleep and enjoyment of life(i.e.Item 9 of BPI)in the three groups at 1 month after treatment was lower than before treatment,with statistically significant differences(P<0.05).The above-mentioned indexes were compared in the three groups at each time point,without statistically significant differenc es(P>0.05).There was statistically significant difference in the total incidence of ADRs among the three groups(P<0.05).Conclusion PCEA with 0.5%lidocaine alone in the treatment of PHN of t

关 键 词：带状疱疹后神经痛 硬膜外自控镇痛 利多卡因 舒芬太尼 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]