针刺在腰椎术后多模式镇痛中的应用:随机对照试验OA

Objective To observe the short-term effect of acupuncture in multimodal analgesia after posterior lumbar interbody fusion(PLIF)in patients with lumbar degenerative diseases.Methods A total of 60 patients with lumbar degenerative diseases undergoing PLIF under general anesthesia were randomly divided into an observation group and a control group,with 30 cases in each one.In the control group,the patients received routine postoperative treatment and patient-controlled intravenous analgesia(PCIA).In the observation group,on the basis of the measures as the control group,the patients received acupuncture within 24 h after operation.The acupoints were bilateral Yaotongdian(EX-UE7),Hegu(LI4),Houxi(SI3),Yanglingquan(GB34),Zusanli(ST36),Sanyinjiao(SP6)and Taixi(KI3).Acupuncture was operated 30 min each time,once daily and for consecutive 7 days.The total PCIA consumption within 48 h after operation,and the number of patients taking etoricoxib tablets during the trial were recorded in the two groups.Before treatment,after 3 days of treatment and after 7 days treatment,the scores of visual analogue scale(VAS),lumbar function of Japanese Orthopaedic Association scale(JOA)and 15-item quality of recovery(QOR-15)scale were observed separately in the two groups.The postoperative hospital stay was recorded in the two groups.Results Compared with the control group,the total PCIA consumption at 0-24 h and 24-48 h after operation and the number of patients taking etoricoxib tablets were reduced in the observation group(P＜0.05).After 3 days of treatment,compared with before treatment,VAS scores decreased(P＜0.05),JOA scores and QOR-15 scores increased(P＜0.05)in each group.After 7 days of treatment,compared with before treatment and after 3 days of treatment,VAS scores were reduced(P＜0.05),JOA and QOR-15 scores were elevated in each group(P＜0.05).After 3 and 7 days of treatment,compared with the control group,VAS scores were lower(P＜0.05),while JOA and QOR-15 scores were higher in the observation group(P＜0.05).The difference in postoperative hospital stay was not significant statistically between the two groups(P＞0.05).Conclusion Acupuncture can reduce the consumption of analgesic drugs,relieve pain and accelerate postoperative recovery after PLIF in a short time.