超声引导下胸椎旁神经阻滞在经皮椎体后凸成形术中的应用

Application of ultrasound-guided thoracic paravertebral nerve block in percutaneous kyphoplasty

回顾性分析2016年1月至2017年6月浙江省瑞安市人民医院收治的68例胸椎骨质疏松性压缩骨折行经皮椎体后凸成形术治疗患者的临床资料，其中31例应用超声引导下胸椎旁神经阻滞（A组），37例应用局麻（B组）。A组患者麻醉时间长于B组（P〈0．05），麻醉满意度（90％）高于B组（68％）（P〈0．05），两组患者住院时间及费用差异无统计学意义（P〉0．05）。2组术后疼痛视觉模拟评分（VAS）均较术前明显减低（P〈0．05），术中操作时A组疼痛VAS低于B组（P〈0．05）。2组平均动脉压及心率比较差异无统计学意义（均P〉0．05）。2组均未发生心脑血管意外事件。提示超声引导胸椎旁神经阻滞是经皮椎体后凸成形术安全、有效的麻醉方法。

From January 2016 to June 2017, 68 patients with thoracic osteoporotic compression fractures were treated with percutaneous kyphoplasty, including 31 cases with ultrasound-guided thoracic paravertebral nerve block （ group A） and 37 cases with local anesthesia （ group B）. The duration of analgesia in group A was longer than that in group B （ P 〈 0. 05 ）. The satisfaetion of anesthesia in group A was higher than that in group B （90% vs. 68% , P 〈0. 05）. There was no significant difference in length of hospital stay and cost between the two groups （P 〉 0. 05 ）. The post-operative VAS scores was significantly lower than those of pre-operation in both groups （ P 〈 0. 05 ）. The intraoperative VAS score of group A was lower than that of group B （ P 〈 0. 05 ）. There was no significant difference between the two groups in mean arterial pressure and heart rate （ P 〉 0.05 ）. No cardiovascular and cerebrovascular adverse reaetions occurred in both groups. Ultrasound-guided thoracic paravertebral nerve block is a safe and effective method used in percutaneous kyphoplasty.