摘要
目的:评价复方倍他米松联合罗哌卡因行枕神经阻滞(occipital nerve block,ONB)对开颅术后急性枕神经痛的治疗效果和安全性。方法:回顾性分析2012年1月至2020年5月期间首都医科大学附属北京天坛医院就诊的开颅术后急性枕神经痛病人的病历及疼痛科数据库资料,均经单纯利多卡因ONB进行诊断性治疗有效,且接受复方倍他米松联合罗哌卡因行ONB治疗。分析病人ONB前、ONB后1天和ONB后7天疼痛数字评分法(numerical rating scale,NRS)评分;以及出院后1个月、3个月疼痛症状恢复情况。结果:共纳入开颅术后确诊急性枕神经痛病人38例,男17例,女21例,年龄(49.9±8.4)岁。ONB前NRS评分为8.6±1.1,ONB后1天和ONB后7天NRS评分分别降至2.5±1.1和1.5±1.0,不同时间点NRS评分比较差异有统计学意义(P<0.01)。ONB后1个月,29例(76%)病人在无药物治疗的情况下没有出现疼痛,4例(11%)病人必须服用口服镇痛药;5例(13%)病人经历了不需要药物治疗的轻微疼痛。在ONB术后3个月,只有1例(3%)病人需要药物来维持疼痛缓解。ONB后3个月内未观察到不良反应或并发症发生。结论:对于开颅术后急性枕神经痛,复方倍他米松联合罗哌卡因行ONB是一种有效且安全的治疗方式,可提供有效的镇痛,并阻止急性枕神经痛持续发作进一步发展为慢性疼痛。
Objective:To evaluate the efficacy and safety of compound betamethasone combined with ropivacaine for occipital nerve block(ONB)for acute occipital neuralgia after craniotomy.Methods:Retrospective analysis of the medical records and pain database of patients with acute occipital neuralgia after craniotomy treated at Beijing Tiantan Hospital affiliated to Capital Medical University from January 2012 to May 2020.All the patients were effective in diagnostic treatment with lidocaine ONB alone,and they received compound betamethasone and ropivacone for ONB treatment.Pain scores scored by pain numbers numerical rating scale(NRS)before ONB,1 day after ONB and 7 days after ONB,and the recovery of pain symptoms at 1 month and 3 months after discharge were analyzed.Results:There were 17 males and 21 females,aged(49.9±8.4)years,diagnosed with acute occipital neuralgia after craniotomy in this study.The average NRS score before ONB was 8.6±1.1,2.5±1.1 and 1.5±1.0 at the time before ONB,1 day after ONB and 7 days after ONB,respectively.The average NRS difference at each time point was statistically different among the three groups(P<0.01).At the time of 1 month after ONB,29 patients(76%)were pain-free without medication,while 4 patients(11%)received oral analgesics;5 patients(13%)experienced mild pain without medication.At the time of 3 months after ONB,only 1 patient(3%)required medication to maintain pain relief.No adverse reactions or complications were observed within 3 months after ONB.Conclusion:For acute occipital neuralgia after craniotomy,ONB treatment with compound betamethasone and ropivacaine is an effective and safe treatment,which can provide reliable analgesic effect and prevent the acute occipital neuralgia from further developing into chronic pain.
作者
王劭恒
温博也
刘鹏飞
高腾
任浩
罗芳
WANG Shaoheng;WEN Boye;LIU Pengfei;GAO Teng;REN Hao;LUO Fang(Anesthesia and Surgical Intensive Medicine Center,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Anesthesiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Pain Management,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2022年第12期916-920,共5页
Chinese Journal of Pain Medicine
基金
北京卫生系统高层次技术人才(学科骨干)(No.2014-3-035)。
关键词
复方倍他米松
开颅术后
枕神经痛
神经阻滞
compound betamethasone
post craniotomy
occipital neuralgia
nerve block
