射频热凝术前两种局麻药物行三叉神经周围支阻滞对围手术期疼痛管理的效果研究-口腔临床医学专业论文.docxVIP

经阻滞和B组(n=30)手术前24小时予复方盐酸利多卡因2ml行下牙 经阻滞和B组(n=30)手术前24小时予复方盐酸利多卡因2ml行下牙 槽神经阻滞。 结果：试验一，97．5％的患者表示术前24小时的平均疼痛值达到中 度到重度，其中重度者占52．5％，中度者占45％；97．5％的患者术前24 小时的最强疼痛值达到中度到重度，其中重度占85％，中度占12．5％； 睡眠质量评估显示术前24小时只有5％的患者获得正常睡眠，95％的患 者有睡眠障碍，偶发疼痛惊醒占47．5％，频发疼痛惊醒占42．5％。试验 二，神经阻滞A组和B组阻滞24h后较阻滞前及对照组均显著减轻平 均疼痛以及最强疼痛值，同时改善睡眠质量，并增加了镇痛的满意度， 差异均具有统计学意义(尺O．01)；48h后复方盐酸利多卡因组疼痛缓解 及睡眠质量改善情况较阻滞前及对照组差异具有统计学意义(PO．05)， 盐酸利多卡因组疼痛缓解及睡眠质量改善情况较阻滞前及对照组差异 不具有统计学意义(PO．05)。此外，A、B组患者行射频治疗穿刺过程 中神经疼痛发作强度明显较对照组减弱(PO．05)，复方盐酸利多卡因 较盐酸利多卡因效果明显(氏0．05)。 结论：1、大部分三叉神经痛患者经历着围手术期中到重度的疼痛 及睡眠障碍。2、大多数患者在穿刺置管过程中经历了剧烈的疼痛。3、 长效麻醉药复方盐酸利多卡因行外周神经阻滞是缓解三叉神经痛患者 术前和术中穿刺难以忍耐的疼痛的有效途径。 关键词：三叉神经痛；神经阻滞；复方盐酸利多卡因；射频热凝；术 前麻醉 万方数据 Evaluation Evaluation ofof thera)eutic。‘‘。cienc,oftlaerapeutic etticiency ot thethe Analalgeslcesic EffectsE士tects Maria：mentManagement 0I Preoperative Peripheral Nerve Block by Uscing Two Kinds of Local Anaesthetics in Patients with Trigeminal Neuralgia Which ale Undergoing Rac【ioIrequency。lhermocoagul-atlon 01：嘲senan【jangUon Objective：Pain can cause negative emotion of the patients including different degrees of fear,anxiety and depression，etc．These changes not only affect the outcome of pain，but also amplify the pain response and change the patients’ behavior and motion，thus affecting their daily life and work,and even causing painful disability or affecting their life．Therefore，chronic pain has become a kind of disease that seriously endangers human health and has received extensive attention from the international medical field．Among them，the trigeminal neuralgia(TN)is a common chronic refractory neuralgia，known as the worst pain for its grievous degree．There are a lot of methods for treating TN at present，mainly divided into medicines and surgical treatment．When medicines do not work or may cause serious side effects，surgery may be the only solution for some patients．Radiofrequency thermocoagulation(RFT)of trigeminal gasserian ganglion is a commonly used minimally invasive surgical treatment for TN．Most of