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电针辅助局部浸润麻醉对腰椎间盘切除术镇痛效果的观察
齐庆岭,张雅静,杨琨,刘爱峰
0
天津中医药大学第一附属医院,国家中医针灸临床医学研究中心天津 300381;天津中医药大学研究生院天津 301617
摘要:
目的:观察电针辅助局部浸润麻醉对经皮内镜腰椎间盘切除术的镇痛作用。方法:选取2020年5月—2022年4月天津中医药大学第一附属医院南院骨伤科诊治的62例因腰椎间盘突出症行经皮内镜腰椎间盘切除术的患者,随机均分为两组,对照组采用局部浸润麻醉,观察组采用局部浸润麻醉结合电针治疗。分别记录两组患者在麻醉前、切皮、建立通道、神经减压及手术结束时的收缩压(SBP)、舒张压(DBP)、心率(HR);采用视觉模拟评分(VAS)法对上述各时点进行疼痛评估;记录患者术中、术后的不良反应发生情况。结果:在麻醉前、切皮及手术结束时,两组患者的HR、SBP、DBP差异无统计学意义(P>0.05);在建立通道、神经减压时,观察组的HR、SBP及DBP均低于对照组(P<0.05)。在麻醉前、切皮、手术结束时,两组VAS评分比较差异无统计学意义(P>0.05);在建立通道、神经减压时,两组VAS评分均有升高趋势,观察组升高幅度低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:电针治疗辅助局部浸润麻醉法在经皮内镜腰椎间盘切除术中既可增强镇痛效果,又可稳定患者术中的血压、心率,减少不良反应。
关键词:  电针刺  腰椎间盘切除  镇痛效应  不良反应
DOI:10.3969/j.issn.1007-6948.2022.04.008
投稿时间:2022-05-20
基金项目:天津医学会麻醉学分会中青年科研培育基金项目(TJMZJJ-2019-04);天津中医药大学第一附属医院拓新工程科研基金(院201920)
Observation on Analgesic Effect of Electroacupuncture Assisted Local Infiltration Anesthesia on Lumbar Discectomy
QI Qing-ling,ZHANG Ya-jing,YANG Kun
Abstract:
Objective The study was used for evaluating the analgesic effect and safety of electroacupuncture on lumbar disc herniation patients. Methods 62 patients underwent intervertebral canal endoscope minimally invasive surgery were selected for research. According to different methods, all of the patients were grouped (31 cases per group). The patients was given local infiltration anesthesia for control, the patients in the observation group was given the therapy of electroacupuncture and local infiltration anesthesia. HR, SBP, DBP, VAS scores and adverse reactions of the patients were recorded, before anesthesia, in skin cutting, in channel establishment, in nerve root decompression and at the end of the operation. Results There were no significant differences in the indicators of HR, SBP, DBP in patients of two groups before anesthesia (P>0.05). During nerve decompression and at the end of operation, the changes of HR, SBP, DBP of the patients in observation group were less than those in control group, and the indicators of the patients in observation group were lower than those in control group (P<0.05). In the case of the time before anesthesia, skin cutting, and at the end of the operation, VAS scores of the patients in two groups before anesthesia are similar (P>0.05). VAS scores in the two groups of channel establishment and nerve root decompression showed an upward trend, but the rising range of the indicator of the patients in observation group was less than that in control group (P<0.05). The adverse reactions were also reduced. Conclusion Electroacupuncture could maintain the stability of BP and HR. It could reduce the incidence of adverse reactions.
Key words:  Electroacupuncture  lumbar discectomy  analgesic effect  adverse reaction

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