中国药物经济学2025，Vol.20Issue(2)：67-71,76,6.DOI:10.12010/j.issn.1673-5846.2025.02.013
腰椎融合术中应用艾司氯胺酮复合竖脊肌平面阻滞对围术期低阿片类药物镇痛效果的影响
Effect of Esketamine combined with Erector Ridge Muscle Plane Block on Perioperative Opioid Analgesia during Lumbar Fusion
摘要
Abstract
Objective To explore the effect of esketamine combined with erector ridge muscle plane block on perioperative analgesia of opioids during lumbar fusion.Methods A total of 64 patients were selected to receive posterior approach lumbar fusion(1-2 lumbar segments)at the Department of Spine and Joint Surgery of Guigang People's Hospital from January to October 2024 were randomly divided into control group(32 cases with traditional opioid general anesthesia)and experimental group(32 cases with low opioid general anesthesia with esketamine combined with erectus block).The anesthetic effect of the two groups was compared.Results The dosage of remifentanil,the first time and times of pressing the analgesic pump,and the total amount of analgesic relief with hydromorphone in experimental group were better than those in control group(P＜0.05).Systolic blood pressure(SBP)and diastolic blood pressure(DBP)in experimental groups were higher than those in control group at 1 min before anesthesia induction tracheal intubation(T0)and 1 min after tracheal intubation(T1)(P＜0.05).There was no significant difference in SBP and DBP between the experimental group and the control group 1 min before operation(T2)and 1 min after operation(T3)(P＞0.05).The heart rate(HR)of the experimental group was higher than that of the control group at T0,T1,T2 and T3(P＜0.05).There was no difference in the incidence of PCIA agitation between experimental group and control group(P＞0.05).The NRS score at rest(2 h,6 h,12 h,24 h,48 h)of experimental group was lower than that of control group(P＜0.05),and the NRS score during exercise(cough)of experimental group(2 h,6 h)was lower than that of control group(P＜0.05),the NRS score(12 h,24 h)during exercise(cough)in experimental group was lower than that in control group(P＞0.05),and the NRS score(48 h)during exercise(cough)in experimental group was lower than that in control group(P＜0.05).The scores of 15 items of recovery quality Scale(RoQ-15)in experimental group were higher than those in control group at 24 and 48 h after operation(P＜0.05).No blocking-related complications(local anesthetic intoxication,hematoma,nerve injury,intra-abdominal organ injury,puncture site infection)occurred in both groups.The incidence of postoperative adverse reactions in experimental group was lower than that in control group(P＞0.05).Conclusion Esketamine combined with erector ridge muscle plane block during the perioperative period of lumbar fusion can effectively reduce the dosage of opioids,reduce adverse reactions,maintain hemodynamic stability,and accelerate postoperative rehabilitation of patients.关键词
艾司氯胺酮/竖脊肌平面阻滞/腰椎融合术/低阿片类药物镇痛Key words
Ketamine/Vertical spine muscle plane block/Lumbar fusion surgery/Low opioid analgesia分类
医药卫生引用本文复制引用
谢珍桂,李耀松,廖建平..腰椎融合术中应用艾司氯胺酮复合竖脊肌平面阻滞对围术期低阿片类药物镇痛效果的影响[J].中国药物经济学,2025,20(2):67-71,76,6.基金项目
广西壮族自治区卫生健康委员会科研项目(Z-R20241688) （Z-R20241688）
湖北陈孝平科技发展基金会项目(CXPJJH124001-07) （CXPJJH124001-07）
