平衡针在经皮椎间孔镜手术治疗腰椎间盘突出症术中镇痛的研究

Study on Balance Acupuncture Analgesia During Percutaneous Transforaminal Endoscopic Surgery for Lumbar Intervertebral Disc Herniation

目的观察平衡针在经皮侧路椎间孔镜手术中镇痛效果与安全性。方法应用前瞻性随机对照研究方法,以腰椎间盘突出症需行经皮侧路椎间孔镜手术患者为研究对象,共选取60例患者,随机分为观察组和对照组,每组30例。观察组在术前10 min选取腰痛穴采用平衡针针刺,对照组采用术前10 min地左辛静脉注射。观察记录术前(T0)、术中穿刺(T1)、环锯打磨时(T2)、置管完成时(T3)各时段生命体征、痛觉反应及不良反应,分析平衡针联合关节突浸润麻醉的镇痛疗效与安全性。结果观察组患者MAP、HR情况在手术过程中无明显的波动,各时间点差异无统计学意义(P>0.05)。对照组患者在手术过程中MAP、HR明显升高(P<0.05),且对照组MAP、HR在T2和T3高于观察组(P<0.05)。观察组镇痛效果优于对照组(P<0.01)。观察组寒战反应时间、手术时间均短于对照组(P<0.05)。两组均未出现术后不良反应。结论平衡针联合关节突浸润麻醉在经皮侧路椎间孔镜手术中有明确的镇痛疗效及安全性。

Objective To investigate the analgesic effect and safety of balance acupuncture during percutaneous transforaminal endoscopic surgery.Method A prospective randomized controlled trial was carried out.Patients with lumbar intervertebral disc herniation needing percutaneous transforaminal endoscopic surgery were subjects.Sixty patients were enrolled and randomized to observation and control groups,30 cases each.The observation group received balance acupuncture at Yaotong point and the control group,intravenous injection of dezocine,10 min preoperatively.Vital signs,pain response and adverse reactions were observed and recorded before surgery(T0),at intraoperative puncture(T1)and circular sawing and grinding(T2)and on completion of tube placement(T3).The analgesic effect and safety of balance acupuncture plus infiltration anesthesia of articular process were analyzed.Result MAP and HR did not change obviously during surgery in the observation group of patients with no statistically significant differences between various time points(P>0.05).MAP and HR increased obviously during surgery in the control group of patients(P<0.05)and were higher at T2 and T3 than in the observation group(P<0.05).The analgesic effect was better in the observation group than in the control group(P<0.01).Chill reaction time and operation time were shorter in the observation group than in the control group(P<0.05).No postoperative adverse reactions occurred in both groups.Conclusion Balance acupuncture plus infiltration anesthesia of articular process has a definite analgesic effect and safety during percutaneous transforaminal endoscopic surgery.