椎弓根外侧浸润麻醉用于单侧穿刺椎体(后凸)成形术

摘要

Objective To introduce extrapedicular infiltration anesthesia as an improved method of local anesthesia which applied to unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty.Methods From March 2015 to March 2016,20 patients in our hospital received percutaneous vertebroplasty or percutaneous kyphoplasty with 1％ lidocaine local infiltration anesthesia and extrapedicular infiltration anesthesia.The visual analogue score of patients during the operation and whether they needed additional sedative anesthesia were evaluated.The anaesthetic effect of nerve root block was observed.Results The visual analogue score of all the patients ranged from 1 point to 3 point,averagely (2.5 ± 0.7) point.Among the 20 patients,there were 2 cases of 1 point,7 cases of 2 point and 11 cases of 3 point.No patients required additional sedative anesthesia,and no nerve root block effects were observed.Conclusion Extrapedicular infiltration anesthesia provides good local anesthetic effects without significant complications,which deserved further use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.%目的 探讨椎弓根外侧浸润麻醉用于单侧穿刺椎体(后凸)成形术的麻醉效果.方法 2015年3月至2016年3月重庆市第十三人民医院20例患者接受1％利多卡因局部浸润麻醉加椎弓根外侧浸润麻醉后进行单侧穿刺椎体(后凸)成形术.评价患者术中穿刺时疼痛模拟评分(VAS)及是否需要增加芬太尼静脉麻醉,观察患者有无相应脊椎上位神经根的区域阻滞麻醉效应.结果 患者穿刺时疼痛VAS评分为1～3分,平均(2.5±0.7)分,其中,2例1分,7例2分,11例3分.所有患者均没有申请芬太尼静脉麻醉,均无相应脊椎上位神经根的区域阻滞麻醉效应.结论 椎弓根外侧1％利多卡因浸润麻醉可以满足经皮穿刺椎体成术形(PVP)和经皮椎体后凸成形术(PKP)手术单侧穿刺的需要,局部麻醉效果好,未见明显并发症.