硬膜外麻醉在椎间孔镜下治疗腰间盘突出中的麻醉效果分析  

Analysis of the Anesthetic Effect of Epidural Anesthesia in the Treatment of Lumbar Disc Herniation with Intervertebral Foramen Endoscopy

作　　者：马艳丽 MA Yanli(Department of Anesthesiology,Enliang Hospital of Taian County,Anshan City,Liaoning Province,Taian 114100,China)

机构地区：[1]辽宁省鞍山市台安县恩良医院麻醉科,辽宁台安114100

出　　处：《中国医药指南》2021年第36期38-40,共3页Guide of China Medicine

摘　　要：目的研究分析通过椎间孔镜下治疗腰间盘突出采用硬膜外麻醉的效果及安全性。方法选择2016年1月至2018年12月在我院行椎间孔镜治疗的53例腰间盘突出患者为研究对象,根据患者选择麻醉方式的不同分成两组。观察组患者28例,选择硬膜外麻醉;对照组患者25例,选择局部麻醉。记录比较两组患者术前VAS评分和术中疼痛感受,观察两组患者术中有无严重的神经、血管及脊髓损伤,6个月后随访,比较两组患者的生命体征情况、VAS评分、术后功能恢复情况及并发症发生率。结果T_(1)、T_(2)时刻两组各项生命体征无统计学意义(P>0.05),T_(3)、T_(4)时刻,观察组HR、MAP高于对照组,SpO_(2)低于对照组;两组患者术中均无严重的神经、血管及脊髓损伤,术前、术后6个月VAS评分无差异。观察组患者无疼痛9例,轻度疼痛15例,镇痛满意度85.71%;对照组无疼痛2例,轻度疼痛14例,镇痛满意度64%;两组术前、术后1个月、3个月及6个月,ODI评分无统计学意义(P>0.05),观察组并发症率为7.14%,低于对照组28.00%,两组差异有统计学意义(P<0.05)。结论椎间孔镜治疗腰间盘突出是新型的微创手术,具有损伤小、操作简单安全、术后恢复快等诸多优势,但手术需要患者随时保持清醒状态,硬膜外麻醉不仅能满足手术的要求,而且镇痛效果显著,不增加手术风险。Objective To study and analyze the effect and safety of epidural anesthesia in the treatment of lumbar disc herniation through foraminal endoscopy.Methods Fifty-three patients with lumbar disc herniation who underwent intervertebral foraminal endoscopy in our hospital from January 2016 to December 2018 were selected as the research objects,and they were divided into two groups according to the different anesthesia methods chosen by the patients.28 patients in the observation group chose epidural anesthesia;25 patients in the control group chose local anesthesia.Record and compare the preoperative VAS scores and intraoperative pain perception of the two groups of patients.Observe whether the two groups of patients have severe nerve,blood vessel and spinal cord injuries during the operation.Follow-up 6 months later to compare the vital signs,VAS scores,and Postoperative functional recovery and complication rate.Results The vital signs of the two groups at T_(1) and T_(2) were not statistically significant(P>0.05).At T_(3) and T_(4),the HR and MAP of the observation group were higher than those of the control group,and SpO_(2) was lower than that of the control group.There were no serious nerve,blood vessel and spinal cord injuries during the operation between the two groups,and there was no difference in VAS scores before and 6 months after the operation.Nine patients in the observation group had no pain,15 patients had mild pain,and analgesic satisfaction was 85.71%.Two patients in the control group had no pain.There were 14 cases of mild pain,and the satisfaction degree of analgesia was 64%.The ODI scores of the two groups before operation,1 month,3 months and 6 months after operation were not statistically significant(P>0.05).The complication rate in the observation group was 7.14%,lower than 28.00%in the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion Foraminoscope treatment of lumbar disc herniation is a new type of minimally invasive surgery.It has many adv

关 键 词：硬膜外麻醉 镇痛 椎间孔镜 腰间盘突出 

分 类 号：R614[医药卫生—麻醉学]