超声引导颈浅丛神经阻滞对枕下乙状窦后入路颅内占位切除术后慢性疼痛的影响  

Effect of ultrasound-guided superficial cervical plexus block on chronic pain after intracranial space-occupying resection by suboccipital retrosigmoid approach

作　　者：李国明 王瑶瑶 曾敏[1] 彭宇明[1] Li Guoming;Wang Yaoyao;Zeng Min;Peng Yuming(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,北京100070

出　　处：《中国医师进修杂志》2024年第7期584-588,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨超声引导颈浅丛神经阻滞对枕下乙状窦后入路颅内占位切除术后慢性疼痛的影响。方法采用单中心、随机、双盲、平行对照试验方法,连续选择2019年11月至2021年4月首都医科大学附属北京天坛医院择期行枕下乙状窦后入路桥脑小脑角听神经瘤切除术患者106例,采用随机数字表法将患者分为试验组和对照组,每组53例。试验组患者在超声引导下用0.5%罗哌卡因行颈浅丛神经阻滞,对照组给予等体积0.9%氯化钠。术后3个月通过电话随访患者慢性术后疼痛情况和慢性术后疼痛数字等级评定量表(NRS)评分,采用简式McGill疼痛问卷-2(SF-MPQ-2)评估慢性疼痛性质。结果试验组慢性术后疼痛发生率和慢性术后疼痛NRS评分稍低于对照组[39.6%(21/53)比50.9%(27/53)和0(0,2)分比1(0,3)分],但两组比较差异无统计学意义(P>0.05)。两组术后SF-MPQ-2各项评分和总分比较差异无统计学意义(P>0.05)。结论超声引导颈浅丛神经阻滞对枕下乙状窦后入路颅内占位切除患者慢性术后疼痛有一定镇痛效果,但仍需更大样本量的研究进一步验证。ObjectiveTo explore the effect of ultrasound-guided superficial cervical plexus block on chronic pain after intracranial space-occupying resection by suboccipital retrosigmoid approach.MethodsA single-center,randomized,double-blind,parallel controlled trial was conducted on 106 consecutive patients who underwent selective resection of acoustic neuromas in the cerebellopontine angle through the suboccipital retrosigmoid approach in Beijing Tiantan Hospital,Capital Medical University from November 2019 to April 2021.The patients were divided into experimental group and control group by random number table method,with 53 cases in each group.The patients in experimental group underwent superficial cervical plexus block with 0.5%ropivacaine under ultrasound-guided,and the patients in control group received an equal volume of 0.9%sodium chloride.Three months after surgery,the patients were followed up for chronic postoperative pain and the chronic postoperative pain rating scale(NRS)score via telephone.The nature of chronic pain was evaluated using the short-form McGill pain questionnaire-2(SF-MPQ-2).ResultsThe incidence of chronic postoperative pain and the NRS score of chronic postoperative pain in experimental group were slightly lower than those in control group:39.6%(21/53)vs.50.9%(27/53)and 0(0,2)scores vs.1(0,3)scores,but there were no statistical difference between the two groups(P>0.05).There were no statistical difference in SF-MPQ-2 various scores and total score after surgery between the two groups(P>0.05).ConclusionsUltrasound-guided superficial cervical plexus block has a certain analgesic effect on chronic pain after intracranial space-occupying resection by suboccipital retrosigmoid approach,but it still requires further verification through an adequate sample size.

关 键 词：疼痛 手术后 神经阻滞 颈丛阻滞 超声检查 枕下乙状窦后入路 

分 类 号：R614[医药卫生—麻醉学]