利多卡因与罗哌卡因星状神经节阻滞治疗头颈部带状疱疹后神经痛的疗效比较

Efficacy comparison of stellate ganglion block with lidocaine and ropivacaine in the treatment of head and neck postherpetic neuralgia

目的比较利多卡因与罗哌卡因星状神经节阻滞(stellate ganglion block,SGB)治疗头颈部带状疱疹后神经痛(postherpetic neuralgia,PHN)的疗效,为临床治疗提供依据。方法回顾性分析169例头颈部PHN患者的临床资料,所有患者均接受口服药物联合超声引导SGB治疗。其中82例使用1%利多卡因4 mL(利多卡因组),87例使用0.2%罗哌卡因4 mL(罗哌卡因组)进行超声引导SGB。两组患者口服药物相同。比较两组治疗前、治疗后1周、1个月和3个月的视觉模拟评分(visual analogue scale,VAS)、焦虑自评量表(self-rating anxiety scale,SAS)及不良反应情况。结果两组治疗前VAS和SAS评分差异无统计学意义(P>0.05)。两组治疗后1周、1个月和3个月的VAS和SAS评分均低于治疗前,差异有统计学意义(P<0.05)。罗哌卡因组治疗后1周、1个月和3个月的VAS和SAS评分均低于利多卡因组,差异有统计学意义(P<0.05)。两组治疗过程中出现的不良反应情况差异无统计学意义(P>0.05)。结论采用罗哌卡因行超声引导SGB治疗头颈部PHN安全、有效,且疗效优于利多卡因。

Objective To compare the efficacy of lidocaine and ropivacaine on stellate ganglion block(SGB)in the treatment of head and neck postherpetic neuralgia(PHN),in order to provide basis for guiding clinical treatment.Methods We retrospectively analyzed the data of 169 patients with head and neck PHN.All patients received oral medication combined with ultrasound-guided SGB.Among them,82 cases used 1%lidocaine 4 mL(lidocaine group)for ultrasound guided SGB,and 87 cases used 0.2%ropivacaine 4ml(ropivacaine group).The two groups of patients took the same oral medicine.We compared the visual analogue scale(VAS),self-rating anxiety scale(SAS)and adverse reactions data of patients in the two groups before treatment,1 week,1 month and 3 months after treatment.Results There were no statistical significances in VAS and SAS between the two groups before treatment(P>0.05).The VAS and SAS scores of the two groups at 1 week,1 month and 3 months after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).At 1 week,1 month and 3 months after ultrasound-guided SGB treatment,the VAS and SAS scores of ropivacaine group were lower than those of lidocaine group(P<0.05).There was no statistical significance in adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided SGB with ropivacaine is safe and effective in the treatment of head and neck PHN,and the efficacy of ropivacaine is better than lidocaine for SGB treatment.