Facet joints have been described as an important source of low back pain. The value of medial branch blocks in the diagnosis of facet joint mediated pain is considered important. However, the therapeutic value of medi...
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Facet joints have been described as an important source of low back pain. The value of medial branch blocks in the diagnosis of facet joint mediated pain is considered important. However, the therapeutic value of medial branch blocks has not been determined. This study was designed to evaluate the duration of relief obtained and therapeutic value following controlled medial branch blocks with or without adjuvant agents Sarapin (High Chemical Company, Levittown, PA) and Depo-medrol (Pharmacia and Upjohn Company, Kalamazoo, MI). The study population consisted of 180 consecutive patients seen in a single pain management practice, divided into three groups with 60 patients in each group. Group I was treated with local anesthetic only, Group II with the addition of Sarapin, and Group III with the addition of Depo-medrol along with Sarapin. The prevalence of facet joint pain in chronic low back pain was determined as 36%, with a false-positive rate of 25%. Comparison of duration of relief in days with each block in the three groups showed that the relief was significantly superior in Group III compared with Group I and Group II, whereas Group II was superior to Group I.
目的：评价髂筋膜间隙阻滞（ FICB）对小儿股骨干骨折术后早期镇痛效果，观察其对于患儿苏醒期躁动的影响，并与静脉芬太尼作比较。方法选择行单侧股骨干骨折手术患儿36例，经医院伦理委员会批准，分为髂筋膜间隙阻滞组（ FI组）及静脉芬太尼组（ FE组），每组18例。全麻诱导后，两组在超声引导下行髂筋膜间隙穿刺，FI组给予0．2％罗哌卡因（耐乐品）1 ml／kg，FE组给予生理盐水1 ml／kg，术中吸入七氟醚维持麻醉，手术结束前10 min，FE组给予1μg／kg芬太尼，FI组给予等体积生理盐水。术后拔管送入苏醒室（ PACU），记录两组患儿手术时间、拔管时间，术后送入PACU即刻（T0）、10 min（T1）、20 min（T2）的疼痛评分、小儿麻醉恢复期躁动评分（PAED）、PACU停留时间以及术后不良反应的发生情况。结果 T0、T1两时点，FI组疼痛评分低于FE组（ P ＜0．05）；T2时点，两组3-＜8岁患儿疼痛评分差异无统计学意义（ P ＞0．05 ），8-14岁患儿FI组疼痛评分低于FE组（ P ＜0．05）；与FE组相比，FI组三个时点PAED评分均降低，拔管时间及PACU停留时间明显缩短，差异有统计学意义（ P ＜0．05）。结论髂筋膜间隙阻滞能明显减轻小儿股骨干骨折术后苏醒期躁动评分和疼痛评分，效果优于静脉给予芬太尼。
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