【摘要】 探讨硬膜外自控镇痛在脊柱内镜手术应用的临床效果。选择120例脊柱内镜手术治疗腰椎间盘突出症患者,随机分为对照组(0.2%罗哌卡因+0.2%利多卡因局麻),0.1%罗哌卡因+舒芬太尼组(0.1%罗哌卡因+0.3μg/mL舒芬太尼硬膜外自控镇痛),0.2%罗哌卡因+舒芬太尼组(0.2%罗哌卡因+0.3μg/mL舒芬太尼硬膜外自控镇痛),采用视觉模拟(VAS)评分法评估手术中镇痛效果,采用改良Bromage评分评估术毕运动神经阻滞程度,统计0.1%罗哌卡因+舒芬太尼组和0.2%罗哌卡因+舒芬太尼组自控镇痛泵(PCA)按压次数和用药量。结果显示0.2%罗哌卡因和0.3μg/mL舒芬太尼硬膜外自控镇痛应用于脊柱内镜手术,可以达到明显的镇痛效果,满足手术需要,又同时保留患者双下肢运动功能,即有"感觉和运动阻滞分离"现象,从而避免脊柱内镜下马尾神经损伤的可能,值得在临床上推广。更多还原

【Abstract】 To study the clinical effect of epidural self controlled analgesia in the application of endoscopic spinal surgery. 120 patients had Endoscopic spinal surgery to cure Protrusion of Lumbar Intervertebral Disc which were randomly divided into control group(0.2% ropivacaine + 0.2% lidocaine local anesthesia), 0.1% ropivacaine + sufentanil group(0.1% ropivacaine + 0.3 μg/mL sufentanil epidural analgesia), and 0.2% ropivacaine + sufentanil group(0.2% ropivacaine +0.3 μg/mL sufentanil epidural analgesia). Visual analogy score(VAS) was used to evaluate the analgesic effect in the operation;A modified Bromage scale was used to assess the degree of motor nerve block; The press times and dosage of the self-control analgesia pump(PCA) were recorded. 0.2% ropivacaine and 0.3 μg/mL sufentanil epidural self controlled analgesia applied to the spinal endoscopic surgery can not only achieve obvious analgesic effects, meet the needs of the operation, but also retain the motor function of the lower limbs of the patients. It had the phenomenon of "sensory and motor block separation" and avoided the possibility of the injury of cauda equine damaged by the spinal endoscope. And it is worthy of further promotion.更多还原