复合镇痛模式在腰椎手术中的应用

Application of multimodal analgesia in lumbar surgery

目的通过60例腰椎患者手术切口疼痛的不同镇痛方式研究其镇痛效果。方法选用2016年1月~2017年6月的腰椎手术患者60例,采用随机、单盲方式分为常规镇痛组(组1)、超前镇痛组(组2)和复合镇痛组(组3),统计各组患者年龄、性别、饮酒史、吸烟史、手术史、6个月内镇痛药物应用史及术后麻醉清醒后6 h、12 h、24 h、48 h、72 h的VAS评分,采用SPSS 13.0软件进行统计分析。结果 3组镇痛方式中,传统镇痛组术后的VAS评分最高,患者对镇痛治疗的满意度较低;超前镇痛组的VAS评分较传统镇痛组略低,患者对术后镇痛效果基本满意;复合镇痛组的VAS评分最低,患者对术后切口的镇痛效果较为满意。结论复合镇痛方式治疗腰椎手术切口疼痛可以达到满意的镇痛效果。

Objective To study the effect of different analgesic ways in operative incision of 60 cases of lumbar surgery. Methods 60 cases of lumbar surgery from January 2016 to June 2017 were selected and they were divided into 3 groups of routine analgesia group（group 1）, preemptive group（group 2） and multimodal analgesia group（group 3） by random and single blind, the age, sex, drinking history, smoking history, operation history, analgesic medication history and postoperative anesthesia scores of VAS in 6 h, 12 h, 24 h, 48 h and 72 h were analyzed by SPSS 13.0. Results The routine analgesia group had the highest VAS score and lower satisfaction of the analgesic treatment; The VAS score and satisfaction to the analgesic treatment of the preemptive analgesia group was between routine analgesia group and multimodal analgesia group. The multimodal analgesia group had the lowest VAS score and best analgesic effect. Conclusion The analgesic effect of multimodal analgesia can be satisfactory in the operative incision of lumbar surgery.