摘要
目的应用经皮穴位电刺激(TEAS)联合竖脊肌平面阻滞(ESPB)对后入路腰椎手术患者开展镇痛治疗,并探究对患者镇痛及炎症的影响,旨在为临床优化后入路腰椎手术麻醉方案提供参考。方法纳入2021年10月—2023年1月首都医科大学附属北京朝阳医院怀柔医院收治的108例拟行后入路腰椎手术患者,根据简单化随机法(单双号法)分为ESPB组(单号,54例)与TEAS组(双号,54例)。比较2组患者各时间点生命体征、围手术期情况、炎症指标、疼痛情况(VAS)、并发症发生率。结果T1~T2时,TEAS组心率(HR)、平均动脉压(MAP)均显著高于ESPB组(P<0.05);TEAS组苏醒时间、下床活动时间、住院时间、丙泊酚用量、瑞芬太尼用量均显著低于ESPB组(P<0.05);术后1 d,2组炎症指标水平均显著上升(P<0.05),而TEAS组各指标水平显著低于ESPB组(P<0.05);术后24 h内,2组VAS显著下降(P<0.05),且TEAS组术后6 h、12 h、24 h VAS均显著低于ESPB组(P<0.05);TEAS组并发症发生率(12.96%,7/54)与ESPB组(24.07%,13/54)比较差异无统计学意义(P>0.05)。结论TEAS联合ESPB可稳定后入路腰椎手术患者生命体征,减轻术后疼痛感与炎症反应,值得应用。
Objective To explore the influence on analgesia and inflammation in patients undergoing posterior approach lumbar surgery receiving analgesia therapy of transcutaneous electric acupoint stimulation(TEAS)combined with erector spinae plane block(ESPB),so as to provide a reference for clinical optimization of anesthesia regimen for posterior approach lumbar surgery.Methods A total of 108 patients who were admitted to Huairou Hospital,Beijing Chaoyang Hospital Affiliated to Capital Medical University and planned to undergo posterior approach lumbar surgery were included from October 2021 to January 2023.According to the simplified randomization method(single-double number method),they were divided into an ESPB group(single number,n=54)and a TEAS group(double number,n=54).The vital signs at each time point,perioperative conditions,inflammatory indicators,pain status(VAS),and incidence rates of anesthesia complications were compared between the two groups.Results At T1-T2,HR,and MAP in the TEAS group were significantly higher than those in the ESPB group(P<0.05).The awakening time,ambulation time,hospitalization time,propofol dosage,and remifentanil dosage in the TEAS group were significantly shorter or less than those in the ESPB group(P<0.05).The levels of white Inflammatory indicators in the two groups increased significantly 1 day after surgery(P<0.05),but the levels in the TEAS group were significantly lower than those in the ESPB group(P<0.05).Within 24 hours after surgery,the VAS score in both groups decreased significantly(P<0.05),and the VAS in the TEAS group at 6 h,12 h,and 24 h after surgery were significantly lower than those in the ESPB group(P<0.05).There was no statistical significance in the total incidence rate of complications between the TEAS group(12.96%,7/54)and the ESPB group(24.07%,13/54,P>0.05).Conclusion TEAS combined with ESPB can stabilize the vital signs of patients undergoing posterior approach lumbar surgery,and relieve the postoperative pain and inflammatory response.
作者
武晓旭
罗树军
仇秋苹
吴安石
WU Xiaoxu;LUO Shujun;QIU Qiuping;WU Anshi(Department of Anesthesiology,Huairou Hospital,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 101400,China;不详)
出处
《中华全科医学》
2024年第8期1336-1339,共4页
Chinese Journal of General Practice
基金
北京市科技计划项目(z211110006619054)
北京市医药管理中心青年人才培养“青苗”项目(QMH20200704)。
关键词
腰椎间盘突出症
腰椎手术
经皮穴位电刺激
Lumbar disc herniation
Lumbar surgery
Transcutaneous electric acupoint stimulation
作者简介
通信作者:吴安石,E-mail:wuanshi88@163.com。
