The Application Effect of Thoracic Paravertebral Nerve Block Assisted Local Anesthesia in Percutaneous Vertebroplasty in Elderly Patients

Abstract

Abstract: Objective Observe the application effect of thoracic paravertebral nerve block assisted local anesthesia in percutaneous vertebroplasty. Methods Sixty patients undergoing percutaneous vertebroplasty admitted to Jiangsu Province Siyang Hospital from June 2021 to August 2022 were selected as the study subjects and randomly divided into an observation group (thoracic paravertebral nerve block supplemented by local anesthesia) and a control group (local anesthesia) using a numerical table method, with 30 patients in each group. Observe the digital scale score (NRS), mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO₂), Ramsay score, and incidence of adverse reactions in two groups of patients at different time points. Results There was no statistically significant difference in mean arterial pressure (MAP) and heart rate (HR) between the two groups of patients before surgery (T0) and after surgery (T3) (P>0.05). During puncture (T1) and bone cement injection (T2), the MAP and HR of the observation group were lower than those of the control group (P<0.05). There was no statistically significant difference in blood oxygen saturation (SpO2) between the two groups of patients at the four time points T0, T1, T2, and T3 (P>0.05). There was no statistically significant difference in Ramsay score and Numerical Rating Scale (NRS) between the two groups of patients at the end of surgery (T3) (P>0.05). During puncture (T1) and bone cement injection (T2), the Ramsay score and NRS score in the observation group were lower than those in the control group (P<0.05). There were no serious adverse reactions in both groups of patients (P>0.05). Conclusion Patients undergoing percutaneous vertebroplasty can effectively improve intraoperative pain and stabilize their vital signs by using ultrasound-guided thoracic paravertebral nerve block as an auxiliary local anesthesia treatment.

Key words: ultrasound guided, thoracic paravertebral nerve block, local anesthesia, percutaneous vertebro plasty, osteoporotic vertebral compression fracture, anesthetic effect

CLC Number:

R614
R681

NI Hong-yan, KAN Hou-ming, XU Xiang-yang, LI Qian-sheng, WANG Yuan-lin. The Application Effect of Thoracic Paravertebral Nerve Block Assisted Local Anesthesia in Percutaneous Vertebroplasty in Elderly Patients[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(19): 166-170.

References

[1] WANG B, ZHAO C P, SONG L X, et al.Balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fracture: a meta-analysis and systematic review[J]. J Orthop Surg Res,2018,13(1):264.
[2] LUTHMAN S, WIDEN J, BORGSTROM F.Appropriateness criteria for treatment of osteoporotic vertebral compression fractures[J]. Osteoporos Int,2018,29(4):793-804.
[3] 毛海青, 周非非, 蔡思逸, 等. 椎体成形术和椎体后凸成形术加速康复实施流程专家共识[J]. 中华骨与关节外科杂志,2019,12(8):561-571.
[4] 包利帅, 王宏. 经皮椎体后凸成形术的麻醉方式的现状及展望[J]. 现代临床医学,2021,47(1):73-75.
[5] 胥凯凯,薛星星,崔永,等.不同途径胸椎旁神经阻滞在胸腔镜术后镇痛中的应用分析[J].临床和实验医学杂志,2023,22(10):1118-1121.
[6] 邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南——骨质疏松性骨折诊断及治疗原则[J].黑龙江科学,2018,9(2):85-88.
[7] ELY E W, TRUMAN B, SHINTANI A, et al.Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS)[J]. JAMA,2003,289(22):2983-2991.
[8] 李素艳, 赵军红. 骨质疏松性椎体压缩性骨折术后生活质量及危险因素分析[J]. 哈尔滨医药,2021,41(1):48-49.
[9] JI C, RONG Y, WANG J, et al.Risk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures[J]. Pain Physician,2021,24(3):E335-E340.
[10] 张宁, 蔡飞, 李长红, 等. 手法复位结合弯角经皮椎体成形术与单纯经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的效果比较[J]. 中国医药导报,2021,18(21):79-83.
[11] 郑筱亭, 王滨城, 吕碧涛, 等. 经皮椎体成形术治疗骨质疏松性椎体压缩性骨折术中采用椎旁神经阻滞的镇痛效果[J]. 脊柱外科杂志,2021,19(6):377-381.
[12] 王丽阳, 尤肖丽, 许辉, 等. 超声引导下椎旁神经阻滞联合全身麻醉对多发肋骨骨折患者术后镇痛效果及围术期应激反应的影响[J]. 海南医学,2023,34(13):1876-1879.
[13] 王李琴, 方景. 经皮椎体成形术联合椎旁神经阻滞对老年骨质疏松椎体压缩性骨折患者疼痛、关节功能的影响[J]. 实用临床医药杂志,2020,24(9):16-19.
[14] IWASAKI M, EDMONDSON M, SAKAMOTO A, et al.Anesthesia, surgical stress, and “long-term” outcomes[J]. Acta Anaesthesiol Taiwan,2015,53(3):99-104.
[15] 白静, 张银福, 赵义康, 等. 对比分析超声引导下椎旁神经阻滞与肋间神经阻滞在脊柱手术患者应用效果及对血流动力学的影响[J]. 现代生物医学进展,2022,22(21):4148-4152.