| 徐 涛,吴 刚,吴绪才,徐敏燕,黄良库,石 川.竖脊肌平面阻滞与局部浸润麻醉对老年PKP手术患者镇痛效果、应激反应和炎症反应的影响[J].,2024,(16):3143-3147 |
| 竖脊肌平面阻滞与局部浸润麻醉对老年PKP手术患者镇痛效果、应激反应和炎症反应的影响 |
| Effects of Erector Spinae Plane Block and Local Infiltration Anesthesia on Analgesic Effect, Stress Response and Inflammatory Response in Elderly Patients Undergoing PKP Operation |
| 投稿时间：2024-02-08 修订日期：2024-02-27 |
| DOI：10.13241/j.cnki.pmb.2024.16.028 |
| 中文关键词: 竖脊肌平面阻滞 局部浸润麻醉 老年 PKP 镇痛效果 应激反应 炎症反应 |
| 英文关键词: Erector spinae plane block Local infiltration anesthesia Elderly PKP Analgesic effect Stress response Inflammatory response |
| 基金项目:陕西省自然科学基础研究计划面上项目（2022JM-546） |
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| 中文摘要: |
| 摘要 目的：观察竖脊肌平面阻滞（ESPB）与局部浸润麻醉对老年球囊扩张椎体后凸成形术（PKP）手术患者镇痛效果、应激反应和炎症反应的影响。方法：选取2020年4月~2023年4月期间我院收治的110例老年PKP手术患者。根据随机数字表法，将患者分为对照组（接受局部浸润麻醉）、实验组（接受ESPB），各55例。对比两组血流动力学、疼痛视觉模拟评分（VAS）、应激反应和炎症反应情况，同时观察两组不良反应发生情况。结果：穿刺时（T1）~手术结束出室前（T4）时间点，两组平均动脉压（MAP）、心率（HR）先升高后下降，实验组低于同期的对照组（P<0.05）。两组术后6 h、12 h、24 h、48 h，VAS评分升高后下降，实验组的低于同期的对照组（P<0.05）。两组术后1 d，炎症反应指标[C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）]、应激反应指标[去甲肾上腺素（NE）、肾上腺素（E）浓度、皮质醇（Cor）]升高，但实验组低于同期的对照组（P<0.05）。实验组、对照组的不良反应总发生率分别为9.09%、5.45%，组间比较无差异（P>0.05）。结论：与局部浸润麻醉相比，ESPB可更好的控制老年PKP手术患者血流动力学稳定，减轻应激反应和炎症反应，发挥良好的镇痛效果。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of erector spinae plane block (ESPB) and local infiltration anesthesia on analgesic effect, stress response and inflammatory response in elderly patients undergoing balloon kyphoplasty (PKP) operation. Methods: 110 elderly patients undergoing PKP operation who were admitted to our hospital from April 2020 to April 2023 were selected. According to the random number table method, patients were divided into control group(receiving local infiltration anesthesia) and experimental group (receiving ESPB), 55 cases in each group. The hemodynamics, pain visual analogue scale(VAS), stress response and inflammatory response were compared in two groups, and incidence of adverse reactions was observed in two groups. Results: Mean arterial pressure (MAP) and heart rate (HR) in two groups increased first and then decreased from the time of puncture (T1) to the time before the end of operation (T4), and experimental group were lower than those of control group at the same time (P<0.05). The VAS scores in two groups increased and then decreased at 6 h, 12 h, 24 h and 48 h after operation, and experimental group were lower than those of control group (P<0.05). The inflammatory response indexes[C-reactive protein(CRP), tumor necrosis factor-α(TNF-α)] and stress response indexes [norepinephrine (NE), epinephrine (E) concentration, cortisol (Cor)] increased in two groups 1 d after operation, but experimental group were lower than those of control group at the same time(P<0.05). The total incidence of adverse reactions in experimental group and control group was 9.09% and 5.45% respectively, and there was no difference between two groups (P>0.05). Conclusion: Compare with local infiltration anesthesia, ESPB can better control the hemodynamic stability of elderly patients undergoing PKP operation, reduce stress response and inflammatory response, and exert a good analgesic effect. |
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