Anesthetic effect of low concentration ropivacaine ultrasound-guided caudal block for percutaneous endoscopic lumbar discectomy
Objective This study aims to explore the anesthesia effect of low concentration ropivacaine ultra-sound-guided caudal block for percutaneous endoscopic lumbar discectomy.Methods We selected sixty pa-tients who underwent percutaneous endoscopic lumbar discectomy in our hospital from May 2021 to May 2023.The patients were divided into group R and group C using a random number table method,with 30 ca-ses in each group.Group R patients underwent ultrasound-guided caudal block 20 minutes before PLED,while group C patients did not undergo caudal block.Both groups of patients underwent PELD surgery under local anesthesia.The average arterial pressure and heart rate of two groups of patients at baseline(T0),dur-ing local anesthesia(T1),during intervertebral foramen formation(T2),during insertion of the working channel(T3),and during nucleus pulposus removal(T4)were recorded.The pain VAS scores of T1,T2,T3 and T4 in two groups of patients were recorded.The amount of lidocaine used and the number of patients needing sufentanil for rescue analgesia were recorded in two groups.Two groups of patients'satisfaction with anesthesia were recorded.The occurrence of related adverse reactions within 48 hours after anesthesia in two groups of patients was recorded.Results There was no statistically significant difference in average arterial pressure and heart rate between the two groups of patients at different time points(P＞0.05).The pain VAS scores of patients in Group R were significantly lower than those in group C at T1,T2,T3,and T4(P＜0.05).The amount of lidocaine used and the number of sufentanil rescue analgesia cases in group R were significantly lower than those in group C(P＜0.05).The satisfaction with anesthesia in group R was signifi-cantly higher than that in group C(P＜0.05).The incidence of nausea and vomiting in group R was signifi-cantly lower than that in group C(P＜0.05).Conclusion Compared with local anesthesia,0.2％ropiva-caine 20ml ultrasound-guided caudal block combined with local anesthesia for intraforaminal nucleus pulposus extraction has better analgesic effect,lower pain VAS score,reduce the use of local anesthesia lidocaine,re-duce the use of sufentanil and the incidence of adverse reactions,and have higher anesthesia satisfaction.
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