颊针对腰椎融合术后患者的镇痛效应:随机对照试验

Analgesic effect of buccal acupuncture on patients after lumbar spinal fusion:a randomized controlled trial

目的:观察颊针对腰椎融合术后患者疼痛的影响。方法:将60例行腰椎融合术的患者随机分为观察组(30例,脱落1例)和对照组(30例,剔除1例)。对照组予常规麻醉方案;观察组在对照组基础上行颊针治疗,穴取双侧背穴、腰穴、骶穴,每次30 min,首次施针时间为麻醉诱导前,术后每日1次,共3次。比较两组患者术后48 h内舒芬太尼用量、补救镇痛次数及恶心、呕吐发生率;术后2(T1)、8(T2)、12(T3)、24(T4)、48(T5)h静息和运动视觉模拟量表(VAS)评分;术后24、48 h 15项恢复质量量表(QoR-15)评分。结果:观察组术后48 h内舒芬太尼用量和补救镇痛次数均少于对照组(P<0.01);两组T1、T2、T3、T4、T5时间点静息和运动VAS评分比较差异均无统计学意义(P>0.05);观察组术后24、48 h QoR-15评分均高于对照组(P<0.01);观察组恶心发生率低于对照组(P<0.05)。结论:颊针可减少腰椎融合术后疼痛患者镇痛药物用量,促进术后早期康复。

Objective To observe the effect of buccal acupuncture on pain after lumbar spinal fusion.Methods Sixty patients undergoing lumbar spinal fusion were randomly divided into an observation group(30 cases,1 case dropped off)and a control group(30 cases,1 case was eliminated).The patients in the control group were treated with routine anesthesia.On the basis of the control group,the patients in the observation group were treated with buccal acupuncture at bilateral back point,waist point,and sacral point for 30 min per treatment.The first acupuncture was given before anesthesia induction,and then once a day postoperation for two days,totally 3 treatments.The dosage of sufentanil,the number of remedial analgesia,and the incidence of nausea and vomiting within 48 h after surgery were compared between the two groups;rest and motion visual analogue scale(VAS)scores at 2(T1),8(T2),12(T3),24(T4),and 48(T5)h after surgery were observed;the quality of recovery-15 scale(QoR-15)at 24 and 48 h after surgery were evaluated.Results The dosage of sufentanil and the number of remedial analgesia within 48 h after surgery in the observation group were lower than those in the control group(P<0.01).There was no significant statistically difference in rest and motion VAS scores between the two groups in T1,T2,T3,T4 and T5(P>0.05).The QoR-15 scores in the observation group at 24 and 48 h after surgery were higher than those in the control group(P<0.01).The incidence of nausea in the observation group was lower than that in the control group(P<0.05).Conclusion Buccal acupuncture could reduce the amount of postoperative analgesic drugs of patients after lumbar spinal fusion,and promote early postoperative recovery.