加碱性药物硬膜外腔阻滞治疗腰椎间盘突出症

目的 本院骨科的基础研究结果表明，腰椎间盘突出症局部磷脂酶A2（PLA2）活性增高与pH值下降呈负相关。本研究旨在提高局部用药的pH值，观察临床镇痛治疗效果。方法 镇痛门诊患者60例，随机分为两组，对照组（I组）药液pH值5．43；实验组（Ⅱ组）加5％NaHCO31ml，使药液pH值为7．82。穿刺间隙为L3－4或L4－5。结果 两组患者治疗次数、VRS第一次治疗后疼痛减轻百分比，以及VAS疼痛治疗指数均有显著性差异。Ⅱ组治疗次数减少、镇痛的治疗效果明显优于Ⅰ组。结论 加碱性药物硬膜外腔阻滞治疗腰椎间盘突出症能明显提高镇痛治疗效果。

The effect of alkaline lidocaine mixture injected into the epidural space of lumbar disc herniation

Objectives　According to the theory that the level of phospholipase A2(PLA2) activity was negative correlation to pH of disc in lumbar disc herniation, we observed the analgesic effects that the epidural space was injected by alkaline lidocaine mixture.Methods　In the study, 60 cases of lumbar disc herniation were divided into two groups randomly.Control group(group I)used lidocaine mixture of pH5.43；test group (groupⅡ)added 5% NaHCO3 1ml into lidocaine mixture,and pH was 7.82.The puncture of vertebral was lumbar 3～4 or lumbar4～5.Results　The therapeutic frequencies,VRS analgesic 80% of the first treatment and VAS pain index of two groups were significantly different. The therapeutic frequencies of group Ⅰ were more than group Ⅱ.The analgesic effects of group Ⅱ were significantly higher than group Ⅰ.Conclusions　The analgesic effects had been improved when the alkaline lidocaine were injected into the epidural space of lumbar disc herniation.