摘要
目的探讨超声引导下半棘肌间平面阻滞对颈椎后路手术患者术后的影响。方法回顾性分析2022年6月至2024年3月于该院择期行颈椎后路手术的56例患者临床资料,根据麻醉方式的不同分为对照组和研究组,每组28例。对照组采用常规麻醉,研究组在对照组基础上增加半棘肌间隙平面阻滞,比较两组手术节段、手术操作及麻醉维持时间,麻醉药物使用量,主刀医生对术中肌肉松弛效果和患者对镇痛的满意度,术后4、8、24、48 h静息状态数字疼痛评分(NRS),48 h内补救性镇痛药物和患者自控静脉镇痛(PCIA)使用情况,不良反应发生情况和住院时间、初次离床活动时间、初次肛门排气肠功能恢复时间。结果与对照组比较,研究组术中丙泊酚、瑞芬太尼使用量更少,主刀医生对手术区域肌肉松弛效果的满意度和患者对术后48 h镇痛的满意度更高,术后4、8 h NRS评分及术后48 h内补救性镇痛药物和PCIA使用率更低,住院时间更短,差异有统计学意义(P<0.05)。两组手术节段、手术时间、麻醉时间和不良反应发生率比较,差异无统计学意义(P>0.05)。结论超声引导下半棘肌间平面阻滞可提高颈椎后路手术患者术后镇痛的效果,利于患者术后早期恢复。
Objective To explore the effect of ultrasound-guided inter-semispinal muscle plane block in the patients with posterior cervical spine surgery.Methods The clinical data of 56 patients undergoing elective posterior cervical spine surgery in this hospital from June 2022 to March 2024 were analyzed retrospectively.The patients were divided into the control group and study group according to the different anesthesia modes,28 cases in each group.The control group adopted the conventional anesthesia.The study group was added with semispinal muscle space plane block on the control group’s basis.The operation segment,operation,anesthesia maintenance duration,anesthetic drugs use amounts,satisfaction of the chief surgeon on intraoperative muscular flaccidity effect and satisfaction of the patients on analgesia,NRS scores in the rest status at postoperative 4,8,24,48 h and the use situation of remedial analgesic drugs and patient-controlled intravenous analgesia(PCIA)within 48 h,occurrence of adverse reactions,hospitalization duration,time of the first out-of-bed activity and the time of the first passage of gas by anus and intestinal function recovery were compared between the two groups.Results Comparing with the control group,the study group used less propofol and remifentanil during operation,the satisfaction of the chief surgeon on intraoperative muscular flaccidity in the operation region and satisfaction of the patients on analgesia at postoperative 24 h were higher,the NRS score at postoperative 4,8 h,the use rates of remedial analgesic drugs and PCIA within postoperative 48 h were lower,the hospitalization duration was shorter,and the differences were statistically significant(P<0.05).The operation segment,operation time,anesthesia time and incidence rate of adverse reactions had no statistically significant differences between the two groups(P>0.05).Conclusion The ultrasound-guided inter-semispinal muscle plane block could increase the postoperative analgesia effect in the patients with posterior cervical spine surgery,which is conducive to the early recovery of the patients after surgery.
作者
张高娇
木培千
诸光峰
蒋毅
ZHANG Gaojiao;MU Peiqian;ZHU Guangfeng;JIANG Yi(Department of Anesthesiology,Affiliated Wenzhou Municipal Hospital of Integrated Traditional Chinese and Western Medicine,Zhejiang Chinese Medical University,Wenzhou,Zhejiang 325000,China)
出处
《重庆医学》
2026年第1期150-154,共5页
Chongqing Medical Journal
基金
浙江省温州市基础性医疗卫生科技项目(Y2023132)。
关键词
超声引导
半棘肌间平面阻滞
颈椎后路手术
术后镇痛
加速康复外科
ultrasound-guided
inter-semispinal muscle plane block
posterior cervical surgery
postoperative analgesia
enhanced recovery after surgery
