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| 竖脊肌平面阻滞在急性或亚急性期带状疱疹中的镇痛作用 |
| Analgesia of erector spinae plane blockade for acute and subacute herpes zoster |
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| DOI：10.12089/jca.2020.10.013 |
| 中文关键词: 带状疱疹 疼痛 竖脊肌平面阻滞 镇痛 |
| 英文关键词: Herpes zoster Pain Erector spinae plane block Analgesia |
| 基金项目: |
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| 中文摘要: |
目的 评价超声引导下竖脊肌平面阻滞在急性期或亚急性期带状疱疹患者中的镇痛作用。
方法 采用前瞻性随机对照双盲法，纳入胸背部带状疱疹患者52例，男25例，女27例，年龄≥50岁，BMI 18～28 kg/m2，ASA Ⅰ—Ⅲ级，随机分为两组：竖脊肌平面阻滞组（E组）和对照组（C组），每组26例。E组超声引导下竖脊肌平面阻滞注射0.4%罗哌卡因20 ml，C组皮下注射生理盐水2 ml，连续3 d。记录末次治疗后1个月疱疹部位疼痛的发生情况和静息和运动时视觉模拟评分（VAS）、ID-pain量表和McGill疼痛问卷简表（SF-MPQ）评分。记录末次治疗后第4周口服镇痛药物用量及药物相关不良反应的发生情况。
结果 与C组比较，E组末次治疗后1个月疱疹部位疼痛发生率明显降低（P<0.05），末次治疗后1个月静息时VAS疼痛评分、ID-pain量表评分、SF-MPQ的疼痛总分及情感类评分均明显降低（P<0.05），末次治疗后第4周羟考酮使用率明显降低（P<0.05），药物相关不良反应发生率明显降低（P<0.05）。
结论 竖脊肌平面阻滞可明显减轻急性或亚急性期带状疱疹治疗30 d后的疼痛，并减少口服镇痛药物用量和不良反应的发生。 |
| 英文摘要: |
Ojective To evaluate the analgesia effect of erector spinae plane block (ESPB) for acute and subacute herpes zoster.
Methods It was a prospective randomized controlled double-blinded study. Fifty-two patients with acute or subacute thoracic herpes zoster, 25 males and 27 females, aged ≥ 50 years, with a BMI of 18-28 kg/m2, falling into ASA physical status Ⅰ-Ⅲ, were randomized into ESPB group (group E) and control group (group C). ultrasound-guided ESPB with 0.4% ropivacaine of 20 ml was performed in group E once daily for 3 days, while subcutaneous injection with saline of 2 ml was performed in group C. The occurrence of pain at the herpes site 1 month after the last treatment was recorded. The visual analogue scale (VAS), ID-pain scale and short form McGill pain questionnaire (SF-MPQ) were administered 1 month after final intervention. The use of oral analgesics and the occurrence of drug-related adverse reactions in the last week of 1 month after the last treatment were recorded.
Results Compared with group C, the incidence of pain locating in zoster lesion reduced significantly in group E (P < 0.05), the scores of VAS, ID-pain scale, the total pain rating index (PRI) score and PRI B of SF-MPQ were significantly decreased in group E (P < 0.05). As well as the patients using oxycodone and the total incidence of adverse effect with oral analgesics were significant lower in group E than in group C (P < 0.05).
Conclusion Erector spinae plane blockade can significantly reduce pain in acute and subacute herpes zoster after 30 days, and reduce the consumption and side effect of oral analgesics. |
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