Anesthetic effect of ultrasound-guided retrolaminar block during percutaneous transforaminal lumbar spine endoscopic surgery

Qingbo Liu; Chunshu Wang; Shaohua Zheng; Ying Xiao; Jian Wen; Heng DU

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Anesthetic effect of ultrasound-guided retrolaminar block during percutaneous transforaminal lumbar spine endoscopic surgery

VernacularTitle:超声引导下椎板后阻滞应用于经皮椎间孔镜手术的效果
Author: Qingbo LIU ¹ ; Chunshu WANG ¹ ; Shaohua ZHENG ¹ ; Ying XIAO ¹ ; Jian WEN ¹ ; Heng DU ²
Author Information

1. Department of Anesthesiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
2. Department of Orthopedics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Publication Type:Journal Article
Keywords: ultrasound-guided; retrolaminar block; percutaneous endoscopic lumbar discectomy
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(1):117-121
CountryChina
Language:Chinese
Abstract: 【Objective】 To compare the anesthestic effects of ultrasound-guided retrolaminal block （RLB） and local anesthesia during posterior approach vertebral surgery. 【Methods】 Forty patients （ASA physical status Ⅰ or Ⅱ） scheduled for transforaminal lumbar spine endoscopic surgery were recruited and randomly divided into two groups （n=20）： RLB group and local anesthesia group （Group C）. RLB group received the ultrasound-guided retrolaminar block using parasagittal in plane method by an anesthesiologist while Group C received layer-by-layer local infiltration anesthesia according to the operation location； 0.5% ropivacaine of 20 mL was used in the two groups. We recorded visual analogue score （VAS） and Ramsay sedation score at admission （T0）， during skin incision （T1）， puncture （T2）， foraminoplasty （T3）， nerve root decompression （T4） and suture （T5）. We also recorded remedial analgesia rate， scores of the patients’ satisfaction and the intraoperative occurrence of side effects （respiratory depression， tachycardia and hypertension）. The patients were followed up. Their functional status was assessed by the Oswestry Disability Index （ODI） score before surgery and three months after surgery. 【Results】 Compared with Group C， RLB group had significantly decreased visual analogue score at T2-4 and lower remedial analgesia rate （P<0.05）. The patients’ satisfaction was higher in group RLB than in Group C （P<0.05）. The intraoperative occurrence of hypertension and tachycardia were significantly lower in RLB group than in Group C （P<0.05）. ODI score was significantly decreased three months after surgery in both groups （P<0.05）， but it did not differ significantly between the two groups （P>0.05）. 【Conclusion】 Ultrasound-guided RLB can provide satisfactory analgesia with greater safety when trasforaminal endoscopic surgery is used.