Adjuvants to local anesthetics: Current understanding and future trends

Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by itsduration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action. A large array of opioids ranging from morphine, fentanyl and sufentanyl to hydromorphone, buprenorphine and tramadol has been used with varying success. However, their use has been limited by their adverse effect like respiratory depression, nausea, vomiting and pruritus, especially with its neuraxial use. Epinephrine potentiates the local anesthetics by its antinociceptive properties mediated by alpha-2 adrenoreceptor activation along with its vasoconstrictive properties limiting the systemic absorption of local anesthetics. Alpha 2 adrenoreceptor antagonists like clonidine and dexmedetomidine are one of the most widely used class of local anesthetic adjuvants. Other drugs like steroids(dexamethasone), anti-inflammatory agents(parecoxib and lornoxicam), midazolam, ketamine, magnesium sulfate and neostigmine have also been used with mixed success. The concern regarding the safety profile of these adjuvants is due to its potential neurotoxicity and neurological complications which necessitate further research in this direction. Current research is directed towards a search for agents and techniques which would prolong local anaesthetic action without its deleterious effects. This includes novel approaches like use of charged molecules to produce local anaesthetic action(tonicaine and n butyl tetracaine), new age delivery mechanisms for prolonged bioavailability(liposomal, microspheres and cyclodextrin systems) and further studies with other drugs(adenosine, neuromuscular blockers, dextrans).

Different Volumes of Local Anesthetics in Ultrasound-Guided Combined Interscalene-Supraclavicular Block for Traumatic Humeral Fracture

Background: Procedures that require anesthesia of entire length of the arm should have combined Interscalene block (ISB) and Supraclavicular block (SCB) to ensure adequate block. However, dual block requires high dose of local anesthetic (LA). We examined if Ultrasound (U/S) guided block helps to decrease the required volume of LA by visualizing trunks, so we only need injection of LA toward cervical nerve roots C5 and C6 aiming to block branches escaped from supraclavicular block. Patients and methods: Ninety-three patients were randomly allocated into one of three equal groups, each included 31 patients. All patients received SCB 20 ml (10 ml Bupivacaine 0.5% plus 10 ml lidocaine 2%) and ISB with different volumes of LA according to the group as follow: group A: 20 ml, group B: 15 ml, and group C: 10 ml. Result: No significant difference in onset of block (sensory and motor) and duration of block (motor only) between the three groups (P value > 0.05). The duration of sensory block was significantly longer in group A (760.65 ± 30.87 minutes) than in either group B (740.48 ± 21.15 minutes, P value P value P value P value P value P value < 0.001). Conclusion: A reduced volume of LA can be used in ultra sound guided ISB in combined with SCB to give satisfactory level of anesthesia to entire length of the arm, but the sensory block duration and duration of post-operative analgesia will be decreased significantly with decreasing the volume.

Why Labor Epidural Causes Fever and Why Lidocaine Burns on Injection? Role of TRPV 1 Receptor in Hyperthermia: Possible Explanation of Mechanism of Hyperthermia during Labor Epidural and Burning Sensation on Injection of Local Anesthetics

The mechanisms of epidural-associated fever remain incompletely understood [1-3]. We propose that action of local anesthetic on TPRV1. The transient receptor potential cation channel subfamily V member 1 (TRPV1), also known as the capsaicin receptor and the vanilloid receptor can explain this effect and explain mechanism of burning sensation on local anesthetic injected subcutaneously or intramuscular. Role of TRPV1 receptor was not discussed previously in Obstetric Anesthesia literature. Based on available data, we propose that Local Anesthetics work as agonist/antagonist on TPRV1 receptors. Antagonist action may cause hyperthermia through modifying thermoregulation [4], agonist action may cause hyperthermia thru release of IL-6 and other mediators of inflammation [5-10]. Agonist action may explain burning sensation on injection of Local Anesthetics. Burning sensation can be diminished by increasing pH of Local Anesthetic solution, because vanillin receptors are stimulated by acidification through lower pH [11,12].

The effects of local anesthetics on intracellular Ca2+ release from ryanod ine-sensitive Ca2+ stores in gerbil hippocampal neurons

OBJECTIVE: To examine the effects of procaine and lidocaine on intracellular Ca(2+) release from sarcoplasmic reticulum ryanodine-sensitive Ca(2+) stores. METHODS: The experiment was performed on hippocampal slices from 60-80 g male Mongolian gerbils. Levels of intracellular Ca(2+) concentration in the slices were measured by microfluorometry. The slices were perfused with 50 mmol/L KCl containing medium for 30 seconds. Then, the medium was switched to physiological medium. After 5 min of incubation, the slice was perfused with 20 mmol/L caffeine containing physiology medium for 2 min. Following incubation, the slice was superfused with physiological medium until the end of the experiment. The effects of procaine and lidocanin (100 micro mol/L) on caffeine-evoked Ca(2+) release were evaluated by adding them to the medium after high K(+) medium perfusion. RESULTS: Caffeine induced a marked increase in intracellular Ca(2+) concentration which was then decreased 12% upon the addition of procaine (P

Features and Principles the Spread of Local Anesthetic Blockade of the Sciatic Nerve at Depends on the Amount of Anesthetic

Aim: To study the features of local anesthetic solution spreading during sciatic nerve block in dependence on the anesthetic solution volume. Material and Methods: One hundred and sixty nine cases of sciatic nerve blocks done under ultrasonic visualization control were analyzed. Sciatic nerve blocks were performed by lidocaine in volumes 30;25;20;15;12.5;10;7.5;6.5;5;4.5 ml. The cross-section area, equal to local anesthetic spreading, was determined;the extension of the anesthetic solution spreading along sciatic nerve was calculated. Results: The anesthetic agent solution spreads along sciatic nerve in proximal and distal direction, forming a kind of cylinder. The minimum volume of the local anesthetic, which covers sciatic nerve in the whole, is 5 ml. A rare (1.77%) variation of sciatic nerve structure was described, in which tibial and common peroneal nerves develop directly from the branches of sacral plexus. Conclusion: The decrease of the local anesthetic volume leads to reduction of its spreading distance and cross-section area. Ultrasonic visualization can provide for sciatic nerve anatomical peculiarities, which can have an effect on the block quality.

Effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy

AIM : To systematically evaluate the effect of intraperitoneal local anesthetic on pain characteristics after laparoscopic cholecystectomy(LC).METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library. Randomized controlled trials in English that compared the effect of intraperitoneal administration of local anesthetics on pain with that of placebo or nothing after elective LC under general anesthesia were included. The primary outcome variables analyzed were the combined scores of abdominal, visceral, parietal, and shoulder pain after LC at multiple time points. We also extracted pain scores at resting and dynamic states.RESULTS: We included 39 studies of 3045 patients in total. The administration of intraperitoneal local anesthetic reduced pain intensity in a resting state after laparoscopic cholecystectomy: abdominal [standardized mean difference(SMD) =-0.741; 95%CI:-1.001 to-0.48, P < 0.001]; visceral(SMD =-0.249; 95%CI:-0.493 to-0.006, P = 0.774); and shoulder(SMD =-0.273; 95%CI:-0.464 to-0.082, P = 0.097). Application of intraperitoneal local anesthetic significantly reduced the incidence of shoulder pain(RR = 0.437; 95%CI: 0.299 to 0.639, P < 0.001). There was no favorable effect on resting parietal or dynamic abdominal pain.CONCLUSION: Intraperitoneal local anesthetic as an analgesic adjuvant in patients undergoing laparoscopic cholecystectomy exhibited beneficial effects on postoperative abdominal, visceral, and shoulder pain in a resting state.

Effects of Repeated Injection of Local Anesthetic on Sciatic Nerve Blocks Response

In order to examine whether repeated sciatic nerve blocks showed tachyphylaxis and continuity of sciatic nerve with spinal cord affected development of tachyphylaxis when assayed in vivo by duration of depression compound action potentials (CAP), rats were anesthetized with halothane, ventilated, monitored and supported with stable hemodynamics and temperature. Posterior tibial nerve distally and sciatic nerve in thigh were exposed, placed on bipolar silver electrodes for stimulation and recording respectively. Three sequential sciatic nerve blocks were performed between these electrodes using 0.15 ml of 3 % chloroprocaine. Nine rats were chosen to observe the effects of repeated sciatic nerve blocks on CAP. In another 18 rats, a second investigator exposed the sciatic nerve near its origin at spinal cord and randomly performed nerve cut and sham (n=9), and closed the incision blinding the electrophysiologic investigator. The results showed that electrical stimulated tibial nerve induced sciatic nerve Aα/β, Aδ, C fiber mediated CAP waves. CAP amplitudes were remained stable during whole experimental procedure. CAP amplitudes were decreased completely with 3% chloroprocaine blocked sciatic nerve and recovered fully. The duration of CAP depression were reduced with repeated blocks. There were no selective blocked effects on Aα/β, Aδ, C fiber mediated CAP. With sciatic nerve cut proximally, there was no statistical significant tachyphylaxis with 3 % chloroprocaine repeated blocked sciatic nerve, and the duration of first and third blocked Aδ fiber mediated CAP was 108±20 and 92±14 min respectively (P>0.05). In normal rats the duration of first and third blocked Aδ fiber mediated CAP was 110±20 and 75±16 min respectively (P<0.05). It was suggested that tachyphylaxis to local anesthetics can occur in rats repeated blocked sciatic nerve when assayed in vivo by duration of depression CAP. The continuity of sciatic nerve with spinal cord is one of the important factors affecting the development of tachyphylaxis.

The effectiveness of local anesthetic and sodium hyaluronate injection for the posterior disc displacement: A case report

Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.

Kinetics of Local Anesthetic Interactions with Model Membranes: Adsorption and Permeation

Introduction: Local anesthetics (LAs) must be adsorbed to and permeate through membranes to reach their sites of action. The rates of these processes critically affect drug actions at the cellular level and also the in vivo pharmacokinetics of perineurally injected drugs. Therefore, we measured the adsorption equilibria and permeation kinetics of two LAs local anesthetics with markedly different hydrophobicities: tetracaine (TTC, Poctanol:buffer = 3.6 × 103) and procaine (PRO, Poctanol:buffer = 8.1 × 101), in unilamellar membranes of different composition and fluidity. Methods: Interactions with unilamellar vesicles made of dipalmitoylphosphatidylcholine (DPPC), at 23°C (solid gel state) or 45°C (liquid crystal state), without or with cholesterol (Chol), were investigated by a combination of fluorescence and stopped-flow techniques. Membrane adsorption was monitored by the LA’s fluorescence. Membrane permeation was monitored by the decrease of fluorescence intensity of intra-vesicular pyranine, when quenched by neighboring TTC or PRO. Results: Ionized TTC (TTCH+) and procaine (PROH+) adsorb to membranes more slowly and weakly than their neutral counterparts (time constant τ ~ 0.1 sec). Fluidizing of membranes, at the higher temperature (45°C) or by Chol inclusion, accelerated LA adsorption (faster than the mixing time of the stopped-flow device, 0.008 s). Permeation of protonated TTCH+ through the solid gel DPPC membranes (23°C) occurred far more slowly than adsorption, (τ = 36.7 ± 0.7 s, n = 9), and 3 times slower than neutral TTC (τ = 10.9 ± 0.7 s, n = 9);neutral PRO permeated these membranes at the same rate as TTC. Inclusion of Chol with DPPC, disordering the fatty acyl tails of membrane phospholipids while crowding their polar headgroups, slowed permeation of TTC and of PRO to an even greater degree. Conclusions: Local anesthetic permeation through membranes is limited by the transport across the membrane core and not by the initial binding. Drug ionization greatly slows permeation, but greater hydrophobicity does not facilitate it. Lipid crowding caused by Chol, a normal membrane component, slows permeation by disorienting the LA bound at the surface.

Quantum Inverse Measurement Theory Contributing to the Birth of Interpretation System of Quantum Mechanics of Local-Realism and Determinism

The existing interpretation of quantum mechanics is contrary to common sense. The existing quantum mechanical interpretation schemes are puzzling. The confusing theory is unconvincing, and needs to be amended and completed. The successful interpretation program of quantum mechanics of local-realism and determinism is undoubtedly the most attractive. Preparing the interpretation program deserves to be chosen as a research goal. It is a very good premise to believe that an object particle consists of light-knot of monochromatic waves. According to this premise, the erroneous recognition about “superposition principle, wave-particle duality and uncertainty principle” can be corrected. Under this premise, above research goal is achieved by establishing, applying quantum mechanics inverse measurement theory, adhering to the principle that there must be a complete empirical chain in the derivation process of experimental conclusion, and using the side effect caused by accompanying-light to explain the diffraction experiment of object particles. Electron secondarily diffraction and other experiments directly prove that there is the measurement (observation) which may not destroy quantum coherence. The diffraction experiments of all kinds of particles show that the Keeping and playing of the coherence of moving particles in the vacuum have nothing to do with their previous experience. These are the existing experiments, to be found, that support the theory of quantum inverse measurements. The verification experiment of quantum inverse measurement is designed. The absolute superiorities of quantum inverse measurement and the new view of measurement of quantum mechanics are listed. These superiorities are that: it has the characteristics of local-realism and determinism;it is not contrary to common sense and there is no confusing place;it can predict several phenomena that cannot be predicted by other theories. A solid theoretical foundation has been laid for “correctly understanding the microscopic world” and establishment of local realism quantum mechanics.

不同局麻药佐剂在周围神经阻滞中的应用进展

超声引导下周围神经阻滞技术在临床麻醉和术后镇痛中的应用越来越广泛。目前,怎样缩短周围神经阻滞的起效时间、延长所用局麻药的作用时间、降低局麻药的毒性反应、增强周围神经阻滞效果是临床麻醉关注的热点问题。许多学者为了缩短周围神经阻滞麻醉的起效时间,增强阻滞效果,延长阻滞的作用时间,尝试了在局麻药中加入多种佐剂进行研究,对比了在周围神经阻滞中应用不同局麻药佐剂的作用效果。本文将对近年来在周围神经阻滞中应用不同局麻药佐剂的应用和研究进展做一综述,以期为临床麻醉医生进行周围神经阻滞提供指导。

基于营造尺复原的土家族土司建筑断代与营造系统类型探索

土家族土司建筑采取既非官式、也非民居的地方做法,对于历史文献不足、建筑型制系统暂未明晰的地方建筑来说,断代面临难题。通过营造尺复原,建立营造尺序列,据此推断相关建筑年代,探讨土家族土司建筑年代一种判定方法的应用。针对本地区不同营造尺并行现象,提出在官式与民居建筑之外存在另一类地方高级建筑,或可称之为“地方官式建筑”,分属不同营造系统。这一探索有助于深化地域建筑断代研究、厘清我国传统建筑营造体系类型。

Dose-response study of spinal hyperbaric ropivacaine for cesarean section

Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.

口腔局部麻醉药抗菌机制的研究进展

局部麻醉药是口腔门诊手术常用的药物,可以发挥麻醉镇痛效果,减轻患者的疼痛,使临床治疗顺利进行。此外,局部麻醉药还被发现具有抗菌效果,能有效抑制各种细菌和真菌的生长。本文总结了口腔治疗中常用的局部麻醉药(利多卡因、布比卡因、罗哌卡因、阿替卡因等)的抗菌性,探讨了药物抗菌作用的分子机制(包括改变细胞壁和细胞膜的通透性、直接损伤细胞膜、抑制蛋白质及遗传物质的合成、抑制细胞呼吸等),以及与其他药物(抗生素、肾上腺素、阿片类药物等)的相互作用,以期有助于口腔临床治疗对局部麻醉药的选择以及感染的预防与控制。

超长效局麻药的研究进展

多模式镇痛是术后疼痛管理的金标准,以超声引导下的神经阻滞为基础辅以少阿片类药物和足量全程使用的非甾体类抗炎药是目前最主流的多模式镇痛方案。但超声引导下神经阻滞受限于局麻药作用时间,往往为外科手术患者提供不超过8 h的有效术后镇痛,使外科手术患者术后镇痛满意率不高。随着快速康复理念的不断深入研究,如何延长局麻药的作用时间是研究的重点和热点。超长效局麻药包括已经应用于临床的布比卡因脂质体、HTX-011,以及仍处于研究阶段的季铵盐类衍生物等。本文将从具有缓释系统的超长效局麻药、超长效局麻药的新作用通路及靶点、开发全新化合物形式的超长效局麻药进行综述,为后续超长效局麻药的研究与临床应用提供新的思路。

儿科护士局部麻醉剂临床应用采纳意愿模型的构建

目的:探索儿科护士局部麻醉剂临床应用采纳意愿的影响因素。方法:采用自行设计的调查问卷于2022年11月1日—15日对四川省10所医院的251名儿科护士进行调查,基于创新扩散理论和计划行为理论构建儿科护士局部麻醉剂临床应用采纳意愿模型。采用AMOS 24.0软件进行结构方程模型分析。结果:局部麻醉剂临床应用的相对优势和易用性对儿科护士态度有正向影响,局部麻醉剂临床应用的态度、主观规范及感知行为控制对儿科护士的采纳意愿有正向影响。模型卡方自由度比值为1.515,适配度指数为0.910,调整拟合优度指数为0.880,近似误差均方根为0.045,均方根残差为0.020。该模型可解释儿科护士采纳意愿71.4%的变异度。结论:局部麻醉剂临床应用的主观规范、感知行为控制和态度对儿科护士采纳意愿有正向影响,其中,态度对采纳意愿的影响作用最强;局部麻醉剂临床应用的相对优势和易用性通过态度对儿科护士采纳意愿产生正向影响。该模型对儿科护士应用局部麻醉剂减轻儿童静脉穿刺疼痛的采纳意愿有较强的解释力。

课程思政融入《药物分析》局麻药物教学中的探讨

《药物分析》是一门可被建设成为有效的思政教育载体的课程。思政元素与该门专业基础课的融入,可同时实现知识储备、能力提升和德育教育的人才培养目标。局麻药物分析是《药物分析》课程教学内容的重要组成部分之一。在代表性局麻药物的发展背景、局麻药物主要质量控制手段的理论课及典型局麻药相关杂质检查的实验课教学中,采用线上线下教学、理论课与实践课教学相结合的模式,探讨在专业知识传授过程中如何进行价值引领。课程教学以学生为中心,根据课程特点挖掘思政元素,以期最大程度地发挥专业课程的德育作用。

手动膜片钳检测盐酸罗哌卡因及其右旋异构体对HEK293细胞hERG电流的影响

目的研究比较盐酸罗哌卡因和盐酸罗哌卡因右旋异构体对高表达hERG钾通道的HEK293细胞hERG电流的影响。方法用手动膜片钳检测转染后hERG钾通道稳定表达的HEK293细胞电流,多菲莱德做阳性药,将盐酸罗哌卡因和盐酸罗哌卡因右旋异构体依次稀释成30.00、10.00、3.33、1.11、0.37μmol·L^(-1),依次作用于细胞,记录电流变化,计算抑制率。结果盐酸罗哌卡因0.37、1.11、3.33、10、30μmol·L^(-1)对电流Iherg-tail的抑制率分别为(6.12±0.30)%、(13.04±1.20)%、(19.21±0.33)%、(35.56±0.66)%、(65.37±4.17)%,IC_(50)为19.482μmol·L^(-1)(n=15)。盐酸罗哌卡因右旋异构体0.37、1.11、3.33、10.00、30.00μmol·L^(-1)对电流Iherg-tail的抑制率分别为(4.13±3.43)%、(7.34±5.60)%、(9.49±2.75)%、(16.60±0.87)%、(31.36±1.45)%,IC_(50)>30μmol·L^(-1)(n=15)。阳性对照药品多菲莱德0.00185、0.00556、0.01667、0.05000、0.15000μmol·L^(-1)对电流Iherg-tail的抑制率分别为(7.81±2.77)%、(19.67±1.88)%、(57.16±4.39)%、(89.71±3.55)%、(99.66±0.89)%、IC_(50)为0.015μmol·L^(-1)(n=15)。结论和阳性对照药品多菲莱德比较,盐酸罗哌卡因对hERG通道为弱抑制作用,盐酸罗哌卡因右旋异构体对hERG通道为无明显抑制作用。

局部麻醉药抑制肝细胞癌生长的机制研究进展

肝癌是位居我国恶性肿瘤发病率前三的疾病,其中肝细胞癌又是最主要的病理类型。肝癌发病隐匿,很多患者发现已到晚期,虽经手术等治疗,但疗效欠佳。近年来研究发现,局部麻醉药在治疗肝癌领域展现了显著的疗效。本文旨在探讨局部麻醉药抑制肝细胞癌生长的具体机制,包括调节肝癌细胞生长环境、增加NK细胞活性、促进癌细胞凋亡以及抑制细胞增殖和转移等方面,以期为肝癌治疗提供新的思路。

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

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。