低浓度大容量利多卡因混合镇痛液用于颈源性头痛神经阻滞的临床观察

目的观察低浓度大容量与常规浓度剂量的利多卡因混合镇痛液在颈源性头痛神经阻滞治疗上的临床疗效和安全性。方法选用符合颈源性头痛诊断标准的108例患者，分为2组各54例。治疗组以0．1％利多卡因60～80mL加得宝松0．5rnL、甲钴胺1mg。对照组以0．5％利多卡因40mL加得宝松0．5mL、甲钴胺1mg分别行枕神经、Q横突、颈部竖棘痛点阻滞，注射镇痛液3～5mL。每周1次，4次为一个疗程。评价2组临床疗效、疼痛视觉模拟评分（vAs评分）、不良反应。结果2组临床疗效无显著差异。与治疗前比较，2组治疗后1周、治疗后1个月、治疗后3个月、治疗后6个月时的头痛VAS评分均明显低于治疗前。治疗组治疗后各时间点VAS评分均明显低于对照组。治疗组不良反应总发生率明显低于对照组。结论低浓度大容量利多卡因用于颈源性头痛的神经阻滞是一种不良反应少，疗效确切的方法，尤其适用于老年患者的治疗。

Clinical observation of low concentration and high volume lidocaine combined with analgesic liquid on nerve block of patients with cervical headache

Objective To observe the clinical efficacy and safety of low concentration and high volume lidocaine combined with analgesic liquid in nerve block of patients with cervical headache. Methods 108 patients with diagnosed cervical headache were divided into two groups, 54 cases in each group. The treatment group was treated with 60 80 mL 0.1% lidocaine plus 0.5 mL diprospan and 1 mg mecobalamin, while the control group was treated with 40 mL 0.1% lido caine plus 0.5 mL diprospan and 1 mg mecobalamin. Blockage of pain points on occipital nerve, Ca transverse and cervical erector spinae were conducted with 35 mL analgesic liquid injection in both groups, one time for each week, and 4 times was counted as a course. Clinical efficacy, visual ana log scale score（VAS score） and adverse reactions were evaluated in both groups. Results There was no significant difference of clinical efficacy between two groups, whereas VAS scores for headache in 1 week, 1 month, 3 months and 6 months after treatment were significantly lower than those before treatment, and VAS scores at each point and adverse reactions in the treatment group were signifi cantly lower than those in the control group. Conclusion Low concentration and high volume Lido caine is effective for nerve block in patients with cervical headache, and the adverse reactions were less.