小剂量右美托咪定辅助局部麻醉下行经皮椎间孔镜手术的效果及安全性分析

Efficacy and Safety Analysis of Low Dose Dexmedetomidine Assisted Local Anesthesia for Percutaneous Transforaminal Surgery

目的探讨行经皮椎间孔镜手术过程中实施小剂量右美托咪定辅助局部麻醉,对比分析其效果及安全性。方法将江门市新会区中医院2018年1月至2020年9月收治的40例行经皮椎间孔镜手术治疗患者按照随机数字表法平均分成对照组和研究组,每组20例患者。对照组的患者实施常规局部麻醉,研究组的患者实施小剂量右美托咪定辅助局部麻醉。比较两组手术前、置入套管时、手术后的平均动脉压(MAP)、心率(HR)指标及视觉模拟评分(VAS)镇痛评分情况,观察记录两组患者出现的不良反应。结果手术前、置入套管时、手术后,两组MAP、HR各项指标及VAS镇痛评分相比差异无统计学意义(P>0.05);手术过程中置入套管时,研究组患者的MAP、HR指标降低对照组MAP、HR指标升高,且研究组患者的各项指标均明显低于对照组(P<0.05)。手术前、置入套管时、手术后,两组VAS镇痛评分差异无统计学意义(P>0.05);手术过程中置入套管时,研究组患者的VAS镇痛评分明显下降,对照组患者的明显上升,且研究组患者的VAS评分低于对照组(P<0.05)。手术前、置入套管时、手术后整个过程中,研究组的患者不良反应发生率为10.00%,与对照组患者的15.00%相比差异无统计学意义(P>0.05)。结论采用小剂量右美托咪定辅助局部麻醉下治疗经皮椎间孔镜手术患者,能稳定血流动力学指标,镇痛效果显著,安全性佳。

Objective To investigate the implementation of low dose dexmedetomidine assisted local anesthesia during percutaneous foraminal surgery,and to compare its efficacy and safety.Methods A total of 40 cases treated by percutaneous foraminal surgery in Chinese Medicine Hospital of Xinhui District from January 2018 to September 2020 were divided into control and study groups,respectively,with 20 patients,according to the random number table method.Patients in the control group were administered routine local anaesthesia and patients in the study group were administered low dose dexmedetomidine assisted local anaesthesia.The mean arterial pressure(MAP),an indicator of heart rate(HR),and a visual analog scale(VAS)analgesia score were compared between the two groups before,at the time of cannula insertion,and after surgery,and adverse effects were recorded by observation.Results There were no significant differences in any of the indicators of map and HR and vas analgesic score between the two groups before surgery,at the time of cannula placement,and after surgery(P>0.05).During surgery,the map and HR indicators of the study group decreased while the map and HR indicators of the control group increased,and all the indicators of the study group patients were significantly lower than those of the control group(P<0.05).Before surgery,at the time of cannula placement,and after surgery,there was no significant difference in the vas analgesic scores between the two groups(P>0.05).When the cannula was placed during surgery,the vas analgesic scores of the study group patients decreased significantly,those of the control group patients increased significantly,and the vas analgesic scores of the study group patients were lower than those of the control group(P<0.05).Before surgery,at the time of cannula placement,and throughout the procedure after surgery,10.00%of patients in the study group experienced adverse events,which was not significantly different from the 15.00%of patients in the control group(P>0.05).Conclusion The use of low dose dexmedetomidine assisted by local anesthesia in the treatment of patients undergoing percutaneous foraminal surgery can stabilize hemodynamic indexes,has a significant analgesic effect,and has a good safety profile.