【摘要】 目的 探讨小剂量局麻药半月节阻滞麻醉在三叉神经痛射频热凝时止痛的适用性。方法 30例原发性三叉神经痛患者,无神经毁损治疗史。在半月节穿刺成功、回吸、电刺激定位后,注射盐酸利多卡因0.5mg(0.5％利多卡因0.1ml),对麻效的起效时间、先症部位、阻滞完全时间、止痛效果及并发症等进行观察;并观察术后的毁损范围与诊断的符合率。治疗的全过程在心电图、血压等监护下进行。结果 该局麻延长达到阻滞完全的时间,使局麻下热凝时患者配合和神经毁损范围的观察具有可操作性。止痛效果 VAS平均2.30±0.94,基本能够满足止痛的需要。回吸有脑脊液流出时不影响局麻的应用。术后神经毁损范围与诊断完全符合率为79.3％。麻醉期不良反应1例,为眩晕、恶心呕吐。角膜麻痹1例。结论 该局麻方法在三叉神经痛射频治疗半月节热凝时有应用价值。更多还原

【Abstract】 Objective To evaluate the feasibility of trigeminal ganglion block with microdosage lidocaine in the radiofrequency rhizotomy of trigeminal neuralgia. Methods Thirty patients with trigeminal neuralgia were free of nerve damage treatment. After puncturing the trigeminal ganglion successfully,sucking adversely and locationg by using electro-stimulation,0. 5mg hydrochloric acid lidocaine (0.5% lidocaine 0.1ml) was injected. The effective medicine time, the first numb position ,the completely block time,the analgetic effect and the complication were observed. The agreement between the diagnosis and the post - operative damage range was observed simultaneously. The treatment was performed under electrocadio - monitering. Results The local anesthesia method prolonged the time so that the nerve was attained complete blocking,and further improved the manipulation of the patient’s cooperation during thermal coagulation and the observation for the damage range. The analgetic effect VAS was 2.30±0.94, which was satisfied with the analgetic expectation generally. There was 79. 3% agreement between the damage range of the thermal coagulation and the diagnosis. The corneal analgesia was 1 case. Conclusion The method was feasible in the treatment of trigeminal neuralgia by radiofrequency rhizotomy through thermal coagulation.更多还原