蛛网膜下腔与硬膜外间隙联合注射乙醇治疗癌痛30例报告

Injection of alcohol into both subarachnoid cavity and epidural space for cancer pain in 30 patients

目的探讨蛛网膜下腔与硬膜外间隙联合注射乙醇治疗癌痛的效果。方法30例癌痛患者在蛛网膜下腔穿刺成功后,注入乙醇达一定平面,拔出腰穿针置入硬膜外导管,再于硬膜外间隙注入同一药物,保留硬膜外导管7-10日,以便必要时重复注药。直到无痛为止。结果本组患者疼痛均有不同程度的减轻,用药后25例(83.3%)患者疼痛完全消失,4例(13.3%)疼痛明显减轻;1例(占3.4%)效果较差。结论乙醇注入蛛网膜下腔与硬膜外间隙有良好的镇痛效果,两者联合用药能升高阻滞平面,可用最小的剂量达到最大的阻滞效果,呼吸循环可保持稳定,不良反应少。

Objective To observe the treatment effect of alcohol injected into subarachnoid cavity and epidural space on cancer pain. Methods Alcohol was injected into a certain level of subarachnoid cavity, and then placing a extradural catheter, the alcohol was injected through the catheter into the epidural space. The catheter was kept for 7-10 days for injecting alcohol repeatedly if needed. The pain was evaluated by visual analogue scale (VAS). Results VAS 1-3 was in 25cases(83.3%), 4-6 in 4 cases(13.3%), 7-9 in 1 case(3.4%) after treatment. Conclusion This method could broaden the block levels and get maximal block effect with the minimal dosage. The analgesic results was satisfied with less adverse reactions.