郭承市 甘伟耀 农信繁

【摘要】 目的：观察超声引导下竖脊肌平面阻滞（erector spinae plane block，ESPB）复合盐酸右美托咪定在椎体成形术中的临床应用效果。方法：选取2019年4-12月于本院择期行椎体成形术的90例患者，按照随机数字表法分为ESPB组（E组）和对照组（C组），每组45例。E组采用超声引导下竖脊肌平面阻滞复合盐酸右美托咪定后行椎体成形术，C组采用利多卡因局麻后行椎体成形术。比较两组不同时间点的MAP、HP及SpO2水平，麻醉效果优良率，不良反应和并发症发生情况。结果：E组T1、T2、T3、T4、T5的MAP及HR均低于C组，差异均有统计学意义（P<0.05）。E组麻醉效果优良率明显高于C组（P<0.05）。两组围术期麻醉相关不良反应和并发症比较，差异均无统计学意义（P>0.05）。结论：超声引导下ESPB复合盐酸右美托咪定在椎体成形术中的麻醉效果较好，生命体征平稳，不良反应少。

【关键词】 超声引导 竖脊肌平面阻滞 右美托咪定 椎体成形术

Application of Erector Spinae Plane Block Combined with Dexmedetomidine in Vertebroplasty/GUO Chengshi， GAN Weiyao， NONG Xinfan. //Medical Innovation of China， 2021， 18（10）： 0-042

[Abstract] Objective： To observe the clinical application effect of ultrasound guide erector spinae plane block （ESPB） combined with Dexmedetomidine in vertebroplasty. Method： A total of 90 patients who underwent elective vertebroplasty in our hospital from April to December 2019 were selected， they were divided into ESPB group （group E） and control group （group C） according to random number table method， 45 cases in each group. Vertebroplasty was performed after ultrasound guided erector spinal block combined with Dexmedetomidine hydrochloride in group E， and vertebroplasty was performed after local anesthesia with Lidocaine in group C. MAP， HP and SpO2 levels at different time points， excellent and good rates of anesthesia effect， adverse reactions and complications were compared between the two groups. Result： MAP and HR of T1， T2， T3， T4 and T5 in group E were lower than those in group C， the differences were statistical significance （P<0.05）. The excellent and good rate of anesthesia effect in group E was significantly higher than that in group C （P<0.05）. There were no significant differences in perioperative anaesthetic-related adverse reactions and complications between the two groups （P>0.05）. Conclusion： ESPB combined with Dexmedetomidine hydrochloride under ultrasound guidance has good anesthesia effect in vertebroplasty， with stable vital signs and less adverse reactions.

[Key words] Ultrasound guided Erector spinae plane block Dexmedetomidine Vertebroplasty

First-authors address： The Second Peoples Hospital of Nanning， Nanning 530031， China

doi：10.3969/j.issn.1674-4985.2021.10.009

骨質疏松性椎体压缩骨折（osteoporotic vertebral compression fracture，OVCF）多发于中老年人，特别是绝经后妇女，是骨质疏松症的严重并发症之一，也是导致患者出现腰背疼痛的主要原因，部分患者骨折后因长期卧床，易并发静脉血栓、坠积性肺炎、褥疮等并发症，严重影响患者生活质量，甚至对患者生命造成严重威胁[1-2]。目前对OVCF患者的治疗多采用保守治疗或行椎体成形术，而椎体成形术多采用局部麻醉，对于合并有心脑肺血管疾病等基础病的患者，围术期长时间的俯卧位、焦虑、恐惧和疼痛等刺激，易引起交感神经系统兴奋，可能诱发或加重心脑肺血管疾病的发作，导致手术中断，即使勉强完成手术对患者远期的转归也是非常不利的。超声引导下竖……