Clinical study of preemptive analgesia in treatment of senile osteoporotic thoracolumbar fracture by percutaneous vertebroplasty
Objective To observe the clinical efficacy of preemptive analgesia in percutaneous vertebroplasty for treatment of pain in senile osteoporotic thoracolumbar fractures.Methods A total of 80 senile osteoporosis patients with single thora-columbar vertebral compression fracture were enrolled,which included 32 males and 48 females,aged 65-85 years old with mean age of 71.3 years old.There were 38 cases of thoracic fracture and 42 of lumbar fracture.All of them were divided into preemptive analgesia group(experimental group,n=40,injected with bucinnazine hydrochloride injection)and placebo group[control group,n=40,injected with 0.9％sodium chloride solution(normal saline injection)]by random number table method.All of them performed percutaneous vertebroplasty,the visual analogue scale(VAS)score,arterial pressure and heart rate be-fore local anesthetic injection,during puncture,during bone cement injection and 6-hour post operation were observed and recorded.The operation time,intraoperative adverse reactions and postoperative patient satisfaction of 2 groups were observed and recorded.Results There was no significant difference in pain score,arterial pressure and heart rate before local anesthetic injection between 2 groups(P＞0.05).During the process of puncture and bone cement injection,the VAS score,arterial pressure and heart rate of experimental group were statistically significantly lower than those of control group[process of puncture:(3.56± 0.87)scores vs(4.75±0.94)scores,(96.25±7.42)mmHg vs(99.75±7.64)mmHg,(88.45±7.84)times/minutes vs(90.42±7.94)times/minutes;process of bone cement injection:(4.25±0.35)scores vs(5.16±0.45)scores,(98.45±7.52)mmHg vs(102.66± 8.65)mmHg,(94.78±7.58)times/minutes vs(98.44±7.45)times/minutes.P＜0.05].There was no significant difference in VAS score,arterial pressure and heart rate 6-hour post operation between 2 groups(P＞0.05).The operation time of experimental group was statistically significantly less than that of control group,and the difference was statistically significant[(37.47±5.80)minutes vs(39.18±6.30)minutes.P＜0.05].There was no significant difference in intraoperative adverse reactions between 2 groups(P＞0.05).The satisfaction of patients in experimental group was significantly better than that in control group,and the difference was statistically significant[87.5％(35/40)vs 60.0％(24/40).P＜0.05].Conclusion It is demonstrated that preemptive analgesia in percutaneous vertebroplasty for senile osteoporotic fractures could effectively relieve intraoperative pain,reduce pain phobia and operation time,ensure patient safety,and increase patient satisfaction,which is worthy of clinical application.
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