椎间孔镜手术中两种硬膜外给药方案比较研究.docVIP

椎间孔镜手术中两种硬膜外给药方案比较研究 　　[摘要] 目的 比较不同硬膜外麻醉给药方案在椎间孔镜微创手术的麻醉效果。 方法 选取椎间镜治疗腰椎间盘突出髓核摘除术的患者40例，随机分为两组（每组20例）：A组患者硬膜外给予0.25%罗哌卡因10 mL，B组患者硬膜外给予舒芬太尼5 μg和0.25%罗哌卡因10 mL。记录两组患者术前（T0）、手术切皮（T1）、扩张通道（T2）、刺激神经根（T3）、摘除髓核（T4）手术结束（T5）等各时段的血压、心率、VAS评分。并随访记录术后1个月VAS评分，患者满意度以及手术相关并发症。术后疗效满意情况评价采用Oswestry功能障碍指数。 结果 B组患者在T3及T4时间点MAP及HR明显低于A组（P0.05）。结论 在?皮椎间孔镜手术中，硬膜外舒芬太尼复合低浓度罗哌卡因，与单纯罗哌卡因相比能减少静脉镇痛药物用量。 　　[关键词] 硬膜外；舒芬太尼；椎间孔镜手术；低浓度罗哌卡因 　　[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701（2018）12-0106-04 　　Comparison of two epidural dosage regimens in percutaneous transforaminal endoscopic discectomy 　　FANG Minbo1 WU Xiaolei1 SANG Peiming2 PAN Zhihao1 　　1.Department of Anesthesiology， Ningbo City Medical Treatment Center Lihuili Hospital， Ningbo 315004，China； 2.Department of Orthopaedics， Ningbo City Medical Treatment Center Lihuili Hospital， Ningbo 315004，China 　　[Abstract] Objective To compare the anesthetic effects of different epidural anesthetic regimens in percutaneous transforaminal endoscopic discectomy. Methods 40 patients with lumbar disc herniation undergoing percutaneous transforaminal endoscopic discectomy were randomly divided into 2 groups （20 cases in each group）： group A was given 10 ml of epidural 0.25% ropivacaine， group B was given 5 μg of Sufentanil and 10 ml of 0.25% ropivacaine epidurally. The blood pressure， heart rate and VAS score of the two groups were recorded before surgery（T0）， at the time of skin incision （T1）， channel dilation （T2）， nerve roots stimulation （T3）， removal of nucleus pulposus （T4） and at the end of surgery（T5）. The VAS score， patient satisfaction and operation-related complications at 1 month after operation were also recorded. Satisfaction of postoperative curative effect was assessed using Oswestry Disability Index. Results The MAP and HR at T3 and T4 of group B were significantly lower than group A（P0.05）. Conclusion Compared with ropivacaine alone， epidural sufentanil combined with low concentration of ropivacaine reduced the dosage of intravenous