摘要
目的探讨亚麻醉剂量的艾司氯胺酮辅助局部麻醉下行经皮椎间孔镜手术中应用的有效性与安全性。方法选择行经皮椎间孔镜下腰椎间盘切除术的患者40例,随机分为对照组20例(采用常规局部麻醉)、实验组20例(术中辅助泵注艾司氯胺酮)。记录两组患者在入手术室时(T0)、切皮时(T1)、椎间孔扩张时(T2)、髓核摘除时(T3)及手术结束时(T4)的平均动脉压(MAP)、心率(HR)、疼痛VAS评分及镇静程度Ramsay评分,并进行分析比较。结果实验组在T1、T2、T3时间点的MAP、HR、疼痛VAS评分明显低于对照组,且镇静程度Ramsay评分高于对照组,差异有统计学意义(P<0.05);两组在T0、T4时间点的MAP、HR、疼痛VAS评分、镇静程度Ramsay评分差异无统计学意义(P>0.05);实验组患者无明显躁动、呼吸抑制等并发症的发生。结论亚麻醉剂量艾司氯胺酮辅助局部麻醉下经皮椎间孔镜腰椎间盘切除术,手术有效、安全。
Objective To investigate the efficacy and safety of subanesthetic esketamine in percutaneous foraminal surgery under local anesthesia.Methods 40 patients undergoing percutaneous lumbar discectomy under foraminal microscope were randomly divided into control group(20 cases)and experimental group(20 cases)with esketamine injection.The mean arterial pressure(MAP),heart rate(HR),pain VAS score and Ramsay score of the degree of sedate were recorded in the two groups at the time of entering the operating room(T0),the time of skin resection(T1),the time of foraminal dilation(T2),the time of nucleus pulposus removal(T3)and the end of surgery(T4).Results MAP,HR and pain VAS scores of the experimental group were significantly lower than those of the control group at T1,T2 and T3 time points,and Ramsay score of sedation degree was higher than that of the control group,the difference was statistically significant(P<0.05);There were no significant differences in MAP,HR,pain VAS score and Ramsay score of sedation between the two groups at T0 and T4 time points(P>0.05);There were no complications such as agitation and respiratory depression in the experimental group.Conclusion Percutaneous foraminal lumbar discectomy under subanesthetic dose esketamine with local anesthesia is effective and safe.
作者
吴君玲
李晓明
WU Jun-ling;LI Xiao-ming(Department of Anesthesiology,Affiliated Hospital of West Anhui Health Vocational College,Lu'an,Anhui 237005,China)
出处
《颈腰痛杂志》
2024年第5期902-905,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
艾司氯胺酮
局部麻醉
经皮椎间孔镜手术
腰椎间盘突出症
esketamine
local anesthesia
percutaneous endoscopic foraminal surgery
lumbar disc herniation
