摘要
目的探讨电针麻醉在老年椎间孔镜手术患者中的镇痛效果与安全性。方法选择2019年5月至2020年5月中国中医科学院广安门医院南区收治的88例行椎间孔镜手术的老年(年龄>65岁)患者为研究对象,按照麻醉方式不同分为两组,每组44例,对照组给予局部浸润麻醉,观察组给予局部浸润麻醉结合电针麻醉。记录两组患者麻醉前、麻醉后、椎间孔镜置入时、神经根减压时、手术结束时的心率、收缩压、舒张压和视觉模拟评分法(VAS)评分,以及围手术期不良反应发生情况。结果心率、收缩压、舒张压的组间和时点间存在交互作用(P<0.01),麻醉前两组心率、收缩压、舒张压比较差异无统计学意义(P>0.05);内镜置入时、减压神经时、手术结束时,观察组心率、收缩压、舒张压变化幅度小于对照组,且观察组低于对照组(P<0.05)。VAS评分组间和时点间存在交互作用(P<0.01),麻醉前两组VAS评分比较差异无统计学意义(P>0.05);内镜置入时、减压神经时、手术结束时,两组VAS评分呈下降趋势,且观察组低于对照组(P<0.05)。观察组总不良反应发生率低于对照组[9.09%(4/44)比25.00%(11/44)](P<0.05)。结论电针麻醉应用于老年椎间孔镜手术患者安全有效,可维持术中血压、心率的稳定性,减少不良反应发生。
Objective To explore the analgesic effect and safety of electroacupuncture anesthesia in jntervertebral foraminal endoscopic surgery in elderly patients.Methods A total of 88 elderly patients(age>65 years old)who needed intervertebral foraminal endoscopic surgery admitted to the South District of Guang′anmen Hospital,China Academy of Chinese Medical Sciences from May 2019 to May 2020 were included.They were divided into two groups according to different anesthesia methods,44 cases in each group:the control group was given local infiltration anesthesia,and the observation group was given local infiltration anesthesia combined with electroacupuncture anesthesia.The heart rate,systolic blood pressure,diastolic blood pressure and visual analogue scale(VAS)scores of the two groups before and after anesthesia,during intervertebral foraminal insertion,nerve root decompression,and at the end of the operation,as well as perioperative adverse reactions were recorded.Results There were interactions in the heart rate,systolic blood pressure,and diastolic blood pressure between groups and time points(P<0.01).There was no statistically significant difference in heart rate,systolic blood pressure and diastolic blood pressure between the two groups before anesthesia(P>0.05);the changes in heart rate,systolic blood pressure and diastolic blood pressure of the observation group were smaller than those of the control group at the time of endoscopic placement,decompression of nerves,and at the end of the operation,and the observation group was lower than the control group(P<0.05).There was an interaction in VAS score between groups and time points(P<0.01).Before anesthesia,there was no significant difference in VAS scores between the two groups(P>0.05);at the time of endoscopic placement,decompression of nerves,and the end of surgery,the VAS scores of the two groups showed a downward trend,and the observation group was lower than the control group(P>0.05).The incidence of total adverse reactions in the observation group was lower
作者
雷剑
罗少波
孙新朝
陈阳村
李军
纪秀波
LEI Jian;LUO Shaobo;SUN Xinchao;CHEN Yangcun;LI Jun;JI Xiubo(Department of Anesthesiology,South District of Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102618,China)
出处
《医学综述》
CAS
2022年第1期180-183,189,共5页
Medical Recapitulate
基金
国家自然科学基金(81973678)
中国中医科学院广安门医院南区科研项目(Y2017-04)。
关键词
老年患者
椎间孔镜手术
电针麻醉
安全性
Elderly patients
Intervertebral foraminal surgery
Electroacupuncture anesthesia
Safety
