探讨腰椎手术后创口疼痛的预防措施

Analysis of the preventive measure of lumbar postoperative wound pain

目的探讨腰椎手术后创口疼痛的预防措施。方法回顾分析2014-10-2015-11在我院行腰椎后路椎弓根内固定术后的130例患者,随机分为两组,一组术中在刀口周围浸润性注射一定量罗哌卡因复合液(实验组),另一组常规接受静脉自控镇痛治疗(对照组),静脉注入的药物为芬太尼。所有患者均进行定期随访,比较两组患者术后刀口VAS疼痛评分及临床疗效。结果实验组总有效率与对照组无明显区别,治疗后2 h、4 h、8 h、12 h、24 h、48 h观察患者疼痛减轻程度无明显差别(P>0.05),但实验组患者并发症明显低于对照组,(P<0.05)。结论腰椎手术术中刀口预防性注射一定量罗哌卡因复合液可有效缓解术后腰部刀口的疼痛,并发症低,方法简单可行,经济实惠,值得临床推广。

Objective To investigate the preventive measure of lumbar postoperative wound pain.Methods From October 2014 to December 2015, 130 patients were enrolled in the study with posterior pedicle screw internal fixation operation. The patients were randomly divided into two groups,one group was injected a certain amount of ropivacaine compound liquid around the incision（experimental group）, another group received intravenous patient-controlled analgesia therapy with fentanyl（control group）. All patients were followed up regularly, the VAS pain score and the clinical curative effect between two groups after operation were compared. Results There was no significant difference between the two groups in the total efficacy. After treatment for 2 h, 4 h, 8 h, 12 h, 24 h, 48 h, there were no significant differences in the degree of pain relief（P〈0.05）,but the incidence rate of complications in the experimental group was significantly lower than that of the control group（P〈0.05）.Conclusion To inject a certain amount of ropivacaine around the incision in the lumbar operation can effectively relieve the postoperative pain of waist knife edge, with low incidence rate of complication, and the method is simple, feasible and affordable, it is worthy of clinical promotion.