李凌超^1,,
李东白¹,
郑鑫²,
汪至勇³,
吴艳盈^4,,
1. 大连医科大学附属第二医院 疼痛科，辽宁 大连 116027
2. 大连医科大学附属第二医院 麻醉科，辽宁 大连 116027
3. 江西省彭泽县人民医院 康复科，江西 九江 332700
4. 大连庄河花园口医院 内科，辽宁 大连 116400

详细信息 作者简介: 李凌超（1982-），男，主治医师。E-mail：lilingchaottk@163.com





通讯作者: 吴艳盈，主治医师。E-mail：19893395@qq.com 中图分类号: R459.9


摘要:目的 比较利多卡因与罗哌卡因星状神经节阻滞（stellate ganglion block，SGB）治疗头颈部带状疱疹后神经痛（postherpetic neuralgia，PHN）的疗效，为临床治疗提供依据。方法 回顾性分析169例头颈部PHN患者的临床资料，所有患者均接受口服药物联合超声引导SGB治疗。其中82例使用1%利多卡因4 mL（利多卡因组），87例使用0.2%罗哌卡因4 mL（罗哌卡因组）进行超声引导SGB。两组患者口服药物相同。比较两组治疗 前、治疗后1周、1个月和3个月的视觉模拟评分（visual analogue scale，VAS）、焦虑自评量表（self-rating anxiety scale，SAS）及不良反应情况。结果 两组治疗前VAS和SAS评分差异无统计学意义（P＞0.05）。两组治疗后1周、1个月和3个月的VAS和SAS评分均低于治疗前，差异有统计学意义（P＜0.05）。罗哌卡因组治疗后1周、1个月和3个月的VAS和SAS评分均低于利多卡因组，差异有统计学意义（P＜0.05）。两组治疗过程中出现的不良反应情况差异无统计学意义（P＞0.05）。结论 采用罗哌卡因行超声引导SGB治疗头颈部PHN安全、有效，且疗效优于利多卡因。
关键词: 利多卡因/
罗哌卡因/
星状神经节阻滞/
带状疱疹后神经痛


Abstract:ObjectiveTo compare the efficacy of lidocaine and ropivacaine on stellate ganglion block (SGB) in the treatment of head and neck postherpetic neuralgia (PHN), in order to provide basis for guiding clinical treatment.MethodsWe retrospectively analyzed the data of 169 patients with head and neck PHN. All patients received oral medication combined with ultrasound-guided SGB. Among them, 82 cases used 1% lidocaine 4 mL (lidocaine group) for ultrasound guided SGB, and 87 cases used 0.2% ropivacaine 4ml (ropivacaine group). The two groups of patients took the same oral medicine. We compared the visual analogue scale (VAS), self-rating anxiety scale (SAS) and adverse reactions data of patients in the two groups before treatment, 1 week, 1 month and 3 months after treatment.ResultsThere were no statistical significances in VAS and SAS between the two groups before treatment (P＞0.05). The VAS and SAS scores of the two groups at 1 week, 1 month and 3 months after treatment were lower than those before treatment, and the differences were statistically significant (P＜0.05). At 1 week, 1 month and 3 months after ultrasound-guided SGB treatment, the VAS and SAS scores of ropivacaine group were lower than those of lidocaine group (P＜0.05). There was no statistical significance in adverse reactions between the two groups (P＞0.05).ConclusionUltrasound-guided SGB with ropivacaine is safe and effective in the treatment of head and neck PHN, and the efficacy of ropivacaine is better than lidocaine for SGB treatment.
Keywords:lidocaine/
ropivacaine/
stellate ganglion block/
postherpetic neuralgia

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