地佐辛超前镇痛联合局麻药在内热针治疗强直性脊柱炎中的麻醉效果观察

Observation on Preemptire Analgesic of Dezocine Combined with Local Anesthetics in Treating Ankylosing Spondylitis with Internal Thermal Acupuncure

目的观察地佐辛联合局麻药在内热针治疗强直性脊柱炎中的麻醉效果及安全性。方法将符合诊断标准的72例强直性脊柱炎患者随机分为观察组与对照组,每组各36例。对照组术前无处理,按照强直性脊柱炎治疗术式进行定点,常规消毒、铺巾。以1%利多卡因局部浸润麻醉,术者针刺完成后接内热针治疗仪,加热20min。观察组术前30min给予地佐辛注射液。术者内热针定点、消毒、局部浸润麻醉等操作与对照组相同,术中密切留意患者血压、心电图、血氧饱和度及呼吸变化。结果与术前比较,术中两组患者NRS疼痛评分均下降,而观察组评分更低,与对照组比较,有显著性差异(<0.05);与术中比较,术后两组患者NRS疼痛评分均上升,但观察组评分低于对照组,有显著性差异(<0.05);术后观察组Ramsay评分上升,与对照组比较,有显著性差异(<0.05)。结论在内热针治疗强直性脊柱炎治疗中小剂量应用地佐辛联合局麻药,可以缓解患者术中、术后疼痛,效果确切,无不良反应,安全性高。

Objective To observe the anesthetic effect and safety of dezocine combined with local anesthetic in treatment of ankylosing spondylitis with internal thermal acupuncture.Methods 72 cases of patients with ankylosing spondylitis were randomly divided into observation group and control group,36 cases in each group.Control group received no treatment before the operation,and it was fixed in accordance with the treatment of ankylosing spondylitis,routine disinfection and towel laying were carried out.Anesthesia was performed with 1%lidocaine topical infusion.After acupuncture,the patient was treated with internal thermal acupuncture and heated for 20 min.Observation group was given dozocine injection 30 min before surgery.The internal thermal acupuncture fixed point,disinfection,local infiltration anesthesia operations were the same as those in control group.During the operation,the patients’blood pressure,electrocardiogram,oxygen saturation and respiratory changes were closely monitored.Results Compared with preoperative,NRS pain scores decreased in both groups during the operation,while observation group scored lower,compared with control group,there was a significant difference(<0.05);compared with intraoperative,NRS pain scores increased after surgery in both groups,and the scores in observation group were lower than those in control group,with significant differences(<0.05).The Ramsay score in postoperative observation group increasedsignificantly compared with control group(<0.05).Conclusion Internal thermal acupuncture combined with low doses of dizocine local anesthetic can relieve the pain during and after operation in treatment of ankylosing spondylitis,the effect is definite,there is no adverse reaction,and the safety is high.