胸椎旁神经阻滞辅助局部麻醉用于老年患者经皮椎体成形术中的应用效果

The Application Effect of Thoracic Paravertebral Nerve Block Assisted Local Anesthesia in Percutaneous Vertebroplasty in Elderly Patients

目的观察胸椎旁神经阻滞辅助局部麻醉在经皮椎体成形术中的应用效果。方法选取2021年6月—2022年8月于江苏省泗阳医院收治的60例经皮椎体成形术患者作为研究对象,按照随机数表法将其分为观察组(胸椎旁神经阻滞辅以局部麻醉)与对照组(局部麻醉),每组30例。观察两组患者于不同时点时数字量表评分(NRS)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)、Ramsay评分及不良反应发生情况。结果两组患者在手术前(T0)和手术结束(T3)时MAP、HR比较,差异无统计学意义(P>0.05)。在穿刺(T1)和骨水泥注入(T2)时,观察组MAP和HR低于对照组,差异有统计学意义(P<0.05)。两组患者血氧饱和度(SpO2)在T0、T1、T2、T3四个时间点比较,差异均无统计学意义,差异有统计学意义(P>0.05)。两组患者在手术结束(T3)时Ramsay评分、数字量表评分(NRS)比较,差异无统计学意义(P>0.05)。在穿刺(T1)和骨水泥注入(T2)时,观察组Ramsay评分、NRS评分均低于对照组,差异有统计学意义(P<0.05)。两组患者均无严重不良反应发生,差异无统计学意义(P>0.05)。结论经皮椎体成形术患者采用超声引导下胸椎旁神经阻滞辅助局部麻醉治疗,可以有效改善患者术中疼痛,稳定患者生命体征。

Objective Observe the application effect of thoracic paravertebral nerve block assisted local anesthesia in percutaneous vertebroplasty.Methods Sixty patients undergoing percutaneous vertebroplasty admitted to Jiangsu Province Siyang Hospital from June 2021 to August 2022 were selected as the study subjects and randomly divided into an observation group(thoracic paravertebral nerve block supplemented by local anesthesia)and a control group(local anesthesia)using a numerical table method,with 30 patients in each group.Observe the digital scale score(NRS),mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2),Ramsay score,and incidence of adverse reactions in two groups of patients at diff erent time points.Results There was no statistically signifi cant diff erence in mean arterial pressure(MAP)and heart rate(HR)between the two groups of patients before surgery(T0)and after surgery(T3)(P>0.05).During puncture(T1)and bone cement injection(T2),the MAP and HR of the observation group were lower than those of the control group(P<0.05).There was no statistically signifi cant diff erence in blood oxygen saturation(SpO2)between the two groups of patients at the four time points T0,T1,T2,and T3(P>0.05).There was no statistically signifi cant diff erence in Ramsay score and Numerical Rating Scale(NRS)between the two groups of patients at the end of surgery(T3)(P>0.05).During puncture(T1)and bone cement injection(T2),the Ramsay score and NRS score in the observation group were lower than those in the control group(P<0.05).There were no serious adverse reactions in both groups of patients(P>0.05).Conclusion Patients undergoing percutaneous vertebroplasty can eff ectively improve intraoperative pain and stabilize their vital signs by using ultrasound-guided thoracic paravertebral nerve block as an auxiliary local anesthesia treatment.