Analysis of effects of ultrasonic-guided bilateral erector spinal muscle block on accelerated rehabilitation surgery for manage-ment of painin elderly patients undergoing PKP
Objective To analyze the effects of ultrasound-guided bilateral erector spinae plane blockduring percutane-ous kyphoplasty(PKP)in the treatment of pain induced by osteoporotic vertebral compression fracture(OVCFs)under acceler-ated rehabilitation management.Methods The clinical data of 73 patients with OVCFs admitted to Department of Orthopae-dics,Xiamen Hospital,Zhongshan Hospital,Fudan University from May 2018 to June 2020 were retrospectively analyzed.All patients underwent PKP.They were divided into two groups according to whether or not erector spinae plane block anesthesia was performed during the operation.The group A(41 cases)received bilateral erector spinae plane block anesthesia under ultra-sound guidance during the operation,and the group B(32 cases)did not receive erector spinae plane block anesthesia interven-tion.The Visual Analogue Scale(VAS)score and Oswestry Disability Index(ODI)score were used to evaluate the effects of surgery and nerve block intervention.TheVAS scores and ODI scores of patients were evaluated before the surgery,during the surgery,and on the first day,1 month and 3 months after the surgery,respectively.Results The clinical symptoms of all pa-tients were effectively relieved after operation.The VAS score of the group A was significantly lower than that of the group B when the patients were turned over to operating bed after erector spinal plane block[(5.34±1.42)vs(7.53±0.95),P＜0.001)].Theintraoperative VAS scoreof the group A was significantly lower than that of the group B[(6.68±0.72)vs(7.75±0.92),P＜0.001)].The postoperative VAS score of the group A was significantly lower than that of the group B when the patients were turned over to operating bed[(2.63±0.89)vs(3.19±0.82),P＜0.05].The VAS score and ODI score of the group A on the first day after surgerywas significantly lower than thoseof the group B[VAS:(1.71±0.60)vs(2.38±0.91),P＜0.001;ODI:(19.39±2.65)vs(25.28±5.15),P＜0.001].There was no significant difference in VAS and ODI scores between bothgroups 1 month after surgery[VAS:(1.71±0.61)vs(2.06±0.56),P＜0.05;ODI(19.68±3.86)vs(22.66±4.32),P＜0.005].There was no significant difference in VAS score and ODI score between bothgroups 3 months after operation[VAS:(1.95±0.50)vs(2.09±0.73),P＞0.05;ODI:(19.32±3.17)vs(19.72±3.48),P＞0.05].No complications of wound infection or bleeding occurred in both groups during the follow-up.Conclusion PKP can effectively relieve the postoperative clinical symptoms in patients with OVCFs.Erector spinal nerve block before operation does not increase the risk of operation,and can effectively relieve perioperative local pain,restore the early function of patients,and improve the satisfaction of patients during hospitalization,which is worthy of clinical promotion.
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