Clinical Study Of Dexmedetomidine For Selective Nerve Root Block In The Treatment Of Lumbar Disc Herniation With Radiculopathy

Objective:More than 80% of people experience some form of low back pain in their lifetime.Low back pain not only affects patients’ daily life and work,reduces productivity,but also causes economic burden to the society.The pain caused by nerve root compression caused by lumbar disc herniation is one of the most common types of low back pain.At present,the main treatment methods are drug therapy,physical therapy,nerve block and surgical treatment.Ultrasound guided selective lumbar nerve root block is the main method of conservative treatment.The traditional drugs used in this treatment include glucocorticoids and local anesthetics.Based on the extensive use of dexmedetomidine in perioperative analgesia.The purpose of this study is to investigate whether adding dexmedetomidine to selective lumbar nerve root block can increase the efficacy of traditional drug treatment.Methods:This control study included 82 patients who underwent selective lumbar nerve root block in our hospital from March 2020 to November 2020.The patients were divided into two groups: local anesthetics + Diprospan group(c),local anesthetics + Diprospan + dexmedetomidine(PDD).In the absence of any sedation,the patient was prepared in the prone position,with pillow under the abdomen,venous access was opened,ECG,BP,Sp O2 were routinely monitored,the injection site was disinfected with Iodophor,sterile sheet was laid,and the convex ultrasonic probe was covered with sterile probe sleeve.A pain doctor experienced in musculoskeletal ultrasound guided nerve root injection with sonosite,Inc.,Bothell,WA,USA.In group C,0.5% lidocaine and 3 mg Diprospan were injected around the nerve root for 5 ml.in group PDD,0.5% lidocaine + dexmedetomidine 1.5 UG/kg + Diprospan for 5ml were injected.After treatment,the puncture site was disinfected and the puncture site was closed with sterile dressing.All patients received selective lumbar nerve root block twice with an interval of 4 days.Results: the beginning and duration of sensory and motor block in group C were significantly different from those in PDD group.Main outcome measures:after 2 weeks and 6 months of treatment,there was no significant difference in VAS score and ODI score between PDD group and C group.But in PDD group,drowsiness appeared 1 hour after treatment,and disappeared after 6 hours.The improvement of night sleep quality could last 48 hours.There were no adverse reactions such as hypotension,bradycardia and respiratory depression in both groups.Conclusion: In conclusion,combined with dexmedetomidine for selective nerve root block in the treatment of lumbar disc herniation with nerve root disease,the long-term effect is not better than the traditional analgesic solution,but can significantly improve the sleep quality of patients.