鸡尾酒镇痛在腰椎后路手术中的疗效观察

Effect of cocktail analgesia on posterior lumbar surgery

目的探究手术切口鸡尾酒镇痛对腰椎后路手术患者术后疼痛的影响。方法选取2018年5月至2019年5月于沈阳医学院附属中心医院就诊的单节段腰椎间盘突出症患者60例为研究对象,采用随机数字表法将其分为试验组和对照组,每组各30例。试验组患者术毕于手术切口局部注射鸡尾酒镇痛剂,对照组患者则于手术切口局部注射等量生理盐水。比较两组患者术后视觉模拟评分法(visual analogue scale,VAS)评分和非精神科住院患者心理评定量表评分。结果术后2 h、6 h、12 h和24 h,试验组患者VAS评分均显著低于同期对照组(均P<0.05),术后48 h,两组患者VAS评分比较差异无统计学意义(P>0.05)。术后24 h,试验组患者焦虑、抑郁、孤独、愤怒评分均显著低于对照组(均P<0.05)。结论腰椎后路手术中切口注射鸡尾酒镇痛剂可减轻患者术后疼痛,有利于患者早期活动,改善患者术后消极情绪,提高患者满意度,值得在脊柱手术中推广使用。

Objective To investigate the effect of cocktail of incisional analgesia on postoperative pain in patients undergoing posterior lumbar surgery.Method A total of 60 patients with single-segmental lumbar disc herniation admitted to the Affiliated Central Hospital of Shenyang Medical College from May 2018 to May 2019 were selected and divided into trial group and control group by random number table method,with 30 patients in each group.Patients in trial group received a local injection of cocktail analgesia,while patients in control group received a local injection of normal saline.Postoperative visual analogue scale(VAS)score and mental status scale in non-psychiatric settings score were compared between the two groups.Result 2 h、6 h、12 h and 24 h after surgery,VAS scores of patients in trial group were significantly lower than those in control group(all P<0.05),and 48 h after surgery,there was no significant difference of VAS score between the two groups(P>0.05).24 h after surgery,the scores of anxiety,depression,loneliness and anger in trial group were significantly lower than those in control group(all P<0.05).Conclusion Intraoperative injection of cocktail analgesics through the incision during posterior lumbar surgery can reduce postoperative pain,facilitate early activity,improve postoperative negative mood,and improve patient satisfaction,which is worth promoting in spinal surgery.