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| ZHU Bin,LIU Xiaoguang.Strategies of anesthesia in percutaneous endoscopic lumbar discectomy: a prospective randomized controlled trial[J].Chinese Journal of Spine and Spinal Cord,2015,(12):1069-1072. |
| Strategies of anesthesia in percutaneous endoscopic lumbar discectomy: a prospective randomized controlled trial |
| Received:August 04, 2015 Revised:October 08, 2015 |
| English Keywords:Percutaneous endoscopic lumbar discectomy(PELD) Anesthesia Pain control randomized controlled trial |
| Fund:国家自然科学基金资助项目（81472041）；北京市卫计委首都卫生行业发展专项基金（2014-2-4094）；北京市科委首都临床特色应用研究（Z141107002514011）；北医三院院临床重点课题（Y66448-09） |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the effect of different local infiltration anesthesia on paincontrol with percutaneous endoscopic lumbar discectomy(PELD). Methods: From February 2015 to June 2015, patients treated with PELD due to lumbar disc herniation in our hospital were selected. Patients were randomly divided into two groups: group A, 1% lidocaine dilution solution; group B, ropivacaine hydrochloride injection 100mg on the basis of group A, with fentanyl citrate injection 0.05mg and ondansetron hydrochloride injection 8mg at pre-operation. The pain control effect was evaluated by VAS scores at the time of lumbar foraminoplasty and annulus fibrosus operation, and re-operation intention immediately after operation and 24 hours after operation. Results: A total of 82 patients were included in the study, 42 patients in group A, and 40 patients in group B. The average pain VAS score(1.1±0.9) and the peak pain VAS score(1.3±0.9) of group B were significantly lower at the time of lumbar foraminoplasty than those of group A(3.2±2.4, 5.1±2.3). There was no significant difference of VAS scores at the time of annulus fibrosus operation between two groups. Re-operation intention of group B was significantly higher than that of group A(95.0% vs 71.4%) immediately after operation, and there was no significant difference between two groups(97.5% vs 97.6%) 24 hours after operation. There were no anesthesia and surgery related complications in two groups． Conclusions: Local anesthesia by using lidocaine and ropivacaine, combined with intravenous fentanyl, can significantly improve the pain control in lumbar endoscopic surgery with no increase of surgical risk. |
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