超声引导下联合右美托咪定竖脊肌平面阻滞对带状疱疹后神经痛的疗效观察

Therapeutic effect of ultrasound-guided erector spinae plane block combined with dexmedetomidine on postherpetic neuralgia

目的评价超声引导下罗哌卡因、甲泼尼龙琥珀酸钠、甲钴胺联合右美托咪定(dexmedetomidine,Dex)竖脊肌平面阻滞对带状疱疹后神经痛的治疗效果。方法选取2023年5月至2024年3月在绍兴市上虞人民医院接受竖脊肌平面阻滞治疗的带状疱疹后神经痛患者60例。采用随机数字表法分为对照组和Dex组,每组30例。除常规药物治疗外,两组患者均行超声引导下竖脊肌平面阻滞。对照组患者注射罗哌卡因、甲钴胺、甲泼尼龙琥珀酸钠混合稀释液,Dex组患者在对照组基础上增加Dex 1μg/kg。比较两组患者的疼痛评分、抑郁与焦虑评分。结果在治疗第1周、治疗第2周及治疗结束后的2周,两组患者的疼痛评分均较治疗前下降;与对照组比较,Dex组患者的疼痛评分下降幅度更大,差异有统计学意义(P<0.05)。两组患者的治疗后抑郁和焦虑评分均较治疗前下降,Dex组患者的抑郁和焦虑评分较对照组下降更明显,差异有统计学意义(P<0.05)。结论超声引导下联合右美托咪定竖脊肌平面阻滞可有效减轻带状疱疹后神经痛患者的疼痛程度,同时可缓解患者的焦虑和抑郁状态。

Objective This investigation evaluates the effectiveness of ultrasound-guided erector spinae plane block,employing a combination of ropivacaine,methylprednisolone sodium succinate,mecobalamin,and an additional administration of dexmedetomidine(Dex),in the treatment of postherpetic neuralgia.Methods A tatol of 60 postherpetic neuralgia patients who underwent erector spinae plane block at Shangyu People’s Hospital of Shaoxing City from May 2023 to March 2024 were selected.To divided patients into control group and Dex group using random number table method,30 cases in each group.Besides conventional medication therapy,both groups received the ultrasound-guided erector spinae plane block.The patients in control group were administered a mixed diluent of ropivacaine,mecobalamin,and methylprednisolone sodium succinate,while the patients in Dex group received an additional dosage of Dex at 1μg/kg.The pain,depression,and anxiety scores were compared between two groups.Results Both groups reported a decrease in pain scores at the end of the first week and second weeks and two weeks after the completion of treatment,compared to pre-treatment levels.The decrease in pain scores in Dex group was significantly greater than that in control group,with a statistically significant difference(P<0.05).After treatment,the depression and anxiety scores of both groups of patients decreased compared to pre-treatment.The scores of the patients in Dex group improved more significantly compared to the patients in control group,and the difference was statistically significant(P<0.05).Conclusion The ultrasound-guided erector spinae plane block,augmented with dexmedetomidine,effectively reduces the intensity of pain in postherpetic neuralgia patients and alleviates their symptoms of anxiety and depression.