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| Clinical application of prone position and low-concentration Ropivacaine under epidural anesthesia for the treatment of lumbar intervertebral disc herniation |
| LIU Hui LI Hong XIONG Zhi-peng |
| Department of Spine Surgery,Second People′s Hospital of Pingxiang City,Jiangxi Province,Pingxiang 337000,China |
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Abstract Objective To explore the clinical application of prone position and low-concentration ropivacaine under epidural anesthesia for the treatment of lumbar intervertebral disc herniation with intervertebral foraminoscope.Methods A total of 97 patients with lumbar intervertebral disc herniation in Second People′s Hospital of Pingxiang City from August to December 2020 were selected and divided into the project group(48 cases)and the control group(49 cases)according to random number table method.Both groups underwent foraminal discectomy at the same time.The control group was in the lateral position and received local anesthesia with Lidocaine,and the project group was in the prone position and epidural anesthesia with Ropivacaine.The visual analogue scales(VAS)scores at 6,12 and 24 hours after surgery,the indicators of vital signs at the time of pre-anesthesia (T0),surgery begins skin ision (T1),intraoperative clamping of the nucleus pulposus to pull the nerve root(T2),suture at the end of the operation (T3),and postoperative adverse reactions occurred at 24 hours after surgery.Results The VAS scores at 12 and 24 hours after surgery of both groups were lower than 6 hours after surgery in this group,the VAS scores at 24 hours after surgery of both groups were lower than 12 hours after surgery in the group,and the VAS score of 6,12 and 24 hours after surgery in the project group was lower than those in the control group in the control group at the same period,the differences were statistically significant(P＜0.05).At T0,the two groups were compared with mean arterial pressure (MAP)and heart rate(HR),with no statistically significant difference(P＞0.05).At T1,T2,T3,the MAP and HR in the project group were lower than those in the control group at the same period,and differences were statistically significant(P＜0.05).The MAP and HR of the project group at T1were lower than those at T0in this group,the MAP and HR of the project group at T2were higher than those at T0in this group,the MAP of the project group at T3was higher than that at T0in this group,the HR of the project group at T3were lower than that at T0in this group,the MAP and HR of the project group at T3were higher than those at T2in this group,and differences were statistically significant(P＜0.05).The MAP and HR of the control group at T1,T2,T3were higher than those at T0in this group,the MAP and HR of the control group at T2,T3were higher than those at T1in this group,the MAP and HR of the control group at T3were lower than those at T2in this group,and differences were statistically significant(P＜0.05).The total incidence of adverse reactions of the project group was lower than that of the control group,with statistically significant difference (P＜0.05).Conclusion The prone position and low-concentration ropivacaine epidural anesthesia can significantly reduce the pain of patients with lumbar disc herniation during foraminal endoscopy,while maintaining the patient′s normal level of vital signs,which is safer.
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