关键词: 超声引导下竖脊肌阻滞, 瑞芬太尼, 老年人, 经皮椎体成形术

Abstract: Objective To investigate the anesthetic effect and adverse reactions of ultrasound-guided erector spinae plane block(ESPB) combined with remifentanil in the elderly patients undergoing percutaneous kyphoplasty(PKP). Methods A total of 60 elderly patients who planned to undergo single PKP were randomly divided into R group and ER group, with 30 cases in each group. R group was given 1% lidocaine for local anesthesia, and ER group was given ultrasound-guided ESPB(3% ropivacaine). Both group received remifentanil 0.05 μg/(kg·min) 5 minutes before anesthesia and maintained until the end of the operation.The scores of Numerical Rating Scale(NRS) and Ramsay sedation score in all patients at the time of anesthesia(T0), skin incision(T1), locating puncture needle(T2), inserting cannula(T3), expanding balloon(T4) and injecting bone cement(T5) were recorded.The adverse reactions such as lower limb motor nerve block, hypoxemia, nausea and vomiting during the surgery were recorded. The static and dynamic NRS scores were recorded 2 h, 6 h, 12 h, and 24 h after surgery in both groups. Results At T2, T3 and T4, the score of NRS in ER group was lower than that in R group(P<0.05), and there was no significant difference in NRS score between the two groups at T0, T1 and T5(P>0.05).There was no significant difference in Ramsay sedation score between the two groups during all periods(P>0.05). No lower limb motor nerve block occurred in both groups, and there were no significant differences in the incidence rates of adverse recations between the two groups during the surgery(P>0.05). The scores of static and dynamic NRS in ER group were lower than those in R group 2 h, 6 h, 12 h and 24 h after surgery(all P<0.05). Conclusions Ultrasound-guided ESPB combined with remifentanil have a good anesthetic analgesic effect in the elderly patients undergoing PKP with less adverse reactions, and the patients feel better during the perioperative period.

Key words: ultrasound-guided erector spinae plane block, remifentanil, aged, percutaneous kyphoplasty