亚甲蓝复合液硬膜外阻滞对椎管内骨转移癌痛的疗效观察

Effect of methylene blue mixture epidural blockade on cancer metastatic bone pain in vertebral canal

目的观察经硬膜外应用亚甲蓝混合曲安奈德对癌椎管内骨转移痛的镇痛效果。方法本组9例，根据癌椎管内骨转移部位不同选择经腰或经骶穿刺，在硬膜外注入不同剂量的亚甲蓝、利多卡因与曲安奈德复合液。结果注射后疼痛消失，5h后出现钝痛，然后减轻，口服氨酚待因有效。强阿片类药药物用量较注射前减少60％以上。有效镇痛时间在5周左右。结论亚甲蓝复合液在硬膜外用药后对癌椎管内骨转移痛有显著疗效，且未见明显并发症。

Objective To observe the effect of epidural, blockade using methylene blue, lidocaine and triamcinolone acetonide mixture on cancer metastatic bone pain in vertebral canal. Methods According to the sites of involving bone of metastatic tumor in vertebral canal, the mixture was injected into lumbar or sacral epidural space in 9 cases. Results The pain disappeared soon after injection. But blunt pain appeared again after 5 hours,then alleviated. It was effective by oral parac： etamol and codeine phosphate tablets to alleviate the pain. The dosage of stronger opioid analgesics was reduced above 60% and its effective time could be lasted to about 5 weeks. Conclusion The effect of methylene blue mixture by epidural injection on cancer meteastatic bone pain in vertebral canal is remarkable without complications.