骶管阻滞下椎间孔镜技术治疗腰突症患者的术中满意度

INTRAOPERATIVE SATISFACTION FOR PATIENTS ACCEPTING PELD UNDER SACRAL ANESTHESIA

摘要:

目的：观察骶管阻滞联合局部浸润麻醉下椎间孔镜技术治疗腰突症患者的术中满意度。 方法：采用前瞻性随机对照研究2017.01.01-2019.05.01保守治疗无效的单节段腰突症患者，随机分为两组：A组为骶管阻滞联合局部浸润麻醉；B组为局部浸润麻醉。观察患者术中镇痛效果、手术疗效、再手术意愿等指标。 结果： A组患者术中椎间孔成形时和椎管内操作时最大视觉模拟评分（visual analogue scale, VAS）低于B组，差异具有统计学意义。A组患者再手术意愿为86.67%，B组仅为46.67%，差异有统计学意义。两组患者术后腰腿痛VAS评分获得明显改善。 结论：骶管阻滞联合局部浸润麻醉下椎间孔镜技术治疗腰突症患者可获得良好的术中镇痛效果，且患者再手术意愿高，是一种值得提倡的椎间孔镜技术操作的麻醉方式。

Abstract:

Objective: to observe intraoperative satisfaction for patients underwent percutaneous endoscopic lumbar discectomy adopting sacral anesthesia combined with local infiltration anesthesia Methods: a prospectively randomized controlled trial was conducted during January 1, 2017 to May 1, 2019 between two groups diagnosed as lumbar disc herniation. Patients from group A underwent surgery adopting sacral anesthesia combined with local infiltration anesthesia, the other group with local infiltration anesthesia. Intraoperative anesthesia efficiency, clinical outcomes and willingness to undergoing further PELD were evaluated. Results: Intraoperative anesthesia efficiency during foraminoplasty and spinal canal manipulation in group A indicated superiority result than group B. Willingness to undergoing further PELD in group A rates high to 86.67%, compared to 46.67% in group B, presented a statistically significant difference（P<0.05 ）. Both groups represented significant improvement regarding VAS score related to back pain and lower extremities pain postoperatively（P<0.05）. Conclusion: Superior intraoperative satisfaction and higher re-operative willingness were revealed among patients undergoing percutaneous endoscopic lumbar discectomy adopting sacral anesthesia combined with local infiltration anesthesia, which was considerable supplement to PELD anesthesia.