曲马多超前镇痛在局麻下胸腰段骨质疏松骨折椎体后凸成形术中的效果
摘要点击次数: 266   全文下载次数: 111   投稿时间:2023-01-31    
作者Author单位AddressE-Mail
李国庆 LI Guo-qing 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
赵华国 ZHAO Hua-guo 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
孙韶华 SUN Shao-hua 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
马维虎 MA Wei-hu 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China weihu_ma@163.com 
李豪杰 LI Hao-jie 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
王扬 WANG Yang 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
陆联松 LU Lian-song 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
阮超越 RUAN Chao-yue 宁波市第六医院脊柱外科, 浙江 宁波 315000 Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315000, Zhejiang, China  
期刊信息:《中国骨伤》2024年,第37卷,第6期,第560-564页
DOI:10.12200/j.issn.1003-0034.20220957
基金项目:
中文摘要:

目的: 探讨术前肌注曲马多用于局麻下行经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)的超前镇痛效果。

方法: 自2019年8月至2021年6月收治118例骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)患者,观察组59例,男26例,女33例;年龄57~80(67.69±4.75)岁;T11 14例,T12 12例,L1 18例,L2 15例;予PKP术前0.5 h肌肉注射曲马多100 mg。对照组59例,男24例,女35例;年龄55~77(68.00±4.43)岁;T11 19例,T12 11例,L1 17例,L2 12例;予肌肉注射等量生理盐水。记录两组手术时间和术中出血量,采用视觉模拟评分(visual analogue scale,VAS)评估两组术前(T0)及术中穿刺时(T1)、放置工作套管时(T2)、球囊扩张时(T3)、骨水泥注入椎体时(T4)、术后2 h (T5)、出院时(T6)的疼痛程度;观察头晕、恶心、呕吐等不良反应,出院时询问患者对再次行PKP手术的接受度。

结果: 118例患者顺利完成经双侧椎弓根入路PKP术,术中均未使用静脉镇静镇痛药物。两组手术时间、术中出血量比较,差异无统计学意义(P>0.05)。观察组T1、T2、T3、T4、T5时的VAS较对照组降低(P<0.05);T6时的VAS比较,差异无统计学意义(P>0.05)。两组T6时的VAS较T0降低(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05),对再次行PKP术的接受度比较,差异有统计学意义(P<0.05)。

结论: 术前0.5 h肌注曲马多用于在局麻下单节段胸腰段骨质疏松骨折椎体PKP术的超前镇痛效果明确,可增加患者术中及术后2 h的舒适度,提高患者手术满意度。
【关键词】曲马多  超前镇痛  椎体后凸成形术  骨质疏松性椎体压缩骨折
 
Effects of tramadol hydrochloride preemptive analgesia in kyphoplasty of thoracolumbar osteoporotic fractures under local anesthesia
ABSTRACT  

Objective To explore preemptive analgesic effect of preoperative intramural tramadol injection in percutaneous kyphoplasty (PKP) of vertebrae following local anesthesia.

Methods From August 2019 to June 2021,118 patients with thoraco lumbar osteoporotic fractures were treated and divided into observation group and control group,with 59 patients in each gruop. In observation group,there were 26 males and 33 females, aged from 57 to 80 years old with an average of (67.69±4.75)years old;14 patients on T11,12 patients on T12,18 patients on L1,15 patients on L2;tramadol with 100 mg was injected intramuscularly half an hour before surgery in observation group. In control group,there were 24 males and 35 females,aged from 55 to 77 years old with an average of (68.00±4.43) years old;19 patients on T11,11 patients on T12,17patients on L1,12 patients on L2;the same amount of normal saline was injected intramuscularly in control group. Observation indicators included operation time,intraoperative bleeding,visual analogue scale (VAS) evaluation and recording of preoperative (T0),intraoperative puncture(T1),and working cannula placement (T2) between two groups of patients,at the time of balloon dilation (T3),when the bone cement was injected into the vertebral body (T4),2 hours after the operation (T5),and the pain degree at the time of discharge(T6);adverse reactions such as dizziness,nausea and vomiting were observed and recorded;the record the patient's acceptance of repeat PKP surgery.

Results All patients were successfully completed PKP via bilateral pedicle approach,and no intravenous sedative and analgesic drugs were used during the operation. There was no significant difference in preoperative general data and VAS(T0) between two groups (P>0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). VAS of T1,T2,T3,T4 and T5 in observation group were all lower than those in control group(P<0.05),and there was no significant difference in T6 VAS (P>0.05). T6 VAS between two groups were significantly lower than those of T0,and the difference was statistically significant (P<0.05). There was no significant difference in incidence of total adverse reactions between two groups (P>0.05). There was a statistically significant difference in the acceptance of repeat PKP surgery (P<0.05).

Conclusion Half an hour before operation,intramuscular injection of tramadol has a clear preemptive analgesic effect for PKP of single-segment thoracolumbar osteoporotic fracture vertebral body under local anesthesia,which could increase the comfort of patients during operation and 2 hours after operation,and improve patients satisfaction with surgery.
KEY WORDS  Tramadol  Preemptive analgesia  Vertebral kyphoplasty  Osteoporosis vertebral compression fracture
 
引用本文,请按以下格式著录参考文献:
中文格式:李国庆,赵华国,孙韶华,马维虎,李豪杰,王扬,陆联松,阮超越.曲马多超前镇痛在局麻下胸腰段骨质疏松骨折椎体后凸成形术中的效果[J].中国骨伤,2024,37(6):560~564
英文格式:LI Guo-qing,ZHAO Hua-guo,SUN Shao-hua,MA Wei-hu,LI Hao-jie,WANG Yang,LU Lian-song,RUAN Chao-yue.Effects of tramadol hydrochloride preemptive analgesia in kyphoplasty of thoracolumbar osteoporotic fractures under local anesthesia[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(6):560~564
阅读全文  下载  查看/发表评论  下载PDF阅读器
关闭




版权所有:《中国骨伤》杂志社京ICP备12048066号-2  版权声明
地址:北京市东直门内南小街甲16号,100700
电话:010-64089487 传真:010-64089792 Email:zggszz@sina.com

京公网安备 11010102004237号