摘要
目的探讨超声引导下胸腰筋膜平面阻滞对行后路腰椎融合术的老年病人术后炎症反应的影响。方法选取2022年9月至2023年6月就诊于山西医科大学第二医院行后正中入路腰椎融合术(1~3个节段)的老年病人40例,采用随机数字表法分为试验组和对照组,每组各20例。试验组行超声引导下双侧胸腰筋膜平面阻滞,每侧各注入0.375%罗哌卡因20 mL;对照组不进行神经阻滞操作。两组术后均予实施自控静脉镇痛(PCIA)。观察并记录两组病人术后6、12、24 h的静息和翻身时疼痛视觉模拟评分法(VAS)评分,并于术前和术后即刻采集病人静脉血,行血清白细胞介素(IL)-6、IL-10和肿瘤坏死因子α(TNF-α)的测定并比较。结果分别比较两组病人术后6、12、24 h的静息和翻身时疼痛VAS评分,试验组均低于对照组(P<0.05);术后即刻血清中的IL-6[(39.03±4.54)ng/L比(44.12±4.62)ng/L]、IL-10[(31.74±3.83)ng/L比(35.57±4.35)ng/L]、TNF-α[(18.44±2.97)ng/L比(21.76±3.75)ng/L]水平比较,试验组均显著低于对照组(P<0.05)。结论超声引导下胸腰筋膜平面阻滞可有效减轻行腰椎融合术的老年病人术后疼痛,减轻围手术期炎症反应。
Objective To explore the effect of ultrasound-guided thoracolumbar fascia plane block on postoperative inflammatory response in elderly patients undergoing posterior lumbar fusion.Methods Forty elderly patients scheduled for posterior median approach lumbar fusion(1-3 segments)at the Second Hospital of Shanxi Medical University between September 2022 and June 2023 were enrolled and randomly assigned to an experimental group(n=20)or a control group(n=20)using the random number table.The experimental group received an ultrasound-guided bilateral thoracolumbar fascial plane block with 20 mL of 0.375%ropivacaine injected on each side.The control group received no nerve block.Both groups received patient-controlled intravenous analgesia(PCIA)postoperatively.Visual analogue scale(VAS)scores for pain at rest and during turning were observed and recorded at 6,12,and 24 hours postoperatively.Venous blood samples were collected preoperatively and immediately postoperatively to measure and compare serum levels of interleukin 6(IL-6),IL-10,and tumor necrosis factor α(TNF-α).Results VAS scores for pain at rest and during turning at 6,12,and 24 hours postoperatively were all significantly lower in the experimental group compared to the control group(P<0.05).Immediate postoperative serum levels of IL-6[(39.03±4.54)ng/L vs.(44.12±4.62)ng/L],IL-10[(31.74±3.83)ng/L vs.(35.57±4.35)ng/L],and TNF-α[(18.44±2.97)ng/L vs.(21.76±3.75)ng/L]were also significantly lower in the experimental group(P<0.05).Conclusion Ultrasoundguided thoracolumbar fascial plane block effectively alleviates postoperative pain and reduces the perioperative inflammatory response in elderly patients undergoing lumbar fusion surgery.
作者
王艺霏
原大江
WANG Yifei;YUAN Dajiang(School of Anesthesiology,Shanxi Medical University,Taiyuan,Shanxi 030000,China)
出处
《安徽医药》
2026年第3期594-597,共4页
Anhui Medical and Pharmaceutical Journal
