摘要
目的比较超声引导下竖脊肌平面(ESP)阻滞与肋间神经阻滞在胸腔镜肺癌根治术术后的镇痛效果.方法择期行胸腔镜下肺癌根治术患者60例,随机分为单纯ESP阻滞组(E组)和单纯肋间神经阻滞组(B组).E组于麻醉诱导前在超声引导下行ESP阻滞,B组于麻醉诱导前在超声引导下行肋间神经阻滞.观察术后1、6、12、24h在静息、咳嗽下的NRS评分,以及非甾体镇痛药给药次数和术后不良反应的发生情况.结果术后6~12h E组静息、咳嗽下的NRS评分明显低于B组(P<0.05),术后1h、24h两组静息及咳嗽下的NRS评分差异无统计学意义,E组对术后镇痛药的需求明显少于B组.术后B组恶心呕吐发生率高于E组(P<0.05).结论超声引导下竖脊肌平面阻滞的胸科手术辅助镇痛方式比肋间神经阻滞更为安全有效.
Objective To compare the postoperative analgesic effect of ultrasound-guided erector spine block(ESP)and ultrasound-guided intercostal nerve block in patients undergoing thoracoscopic radical resection of lung cancer.Methods Sixty patients(49males and 11 females)who underwent video-assisted elective complete surgical lung cancer resection were randomized to receive ESP block(group E)or patient controlled receive intercostal block(group B).The patients in group E were given ESP block before induction of anesthesia and the patients in group B were given intercostal block before induction of anesthesia.The Numerical Rating Scale(NRS)1,6,12 and 24 hours were evaluated after surgery at rest and when coughing.The nonsteroidal anti-inflammatory drugs(Dizosin)consumption and adverse reactions were analyzed during the first 24 hours postoperatively.Results During the 6-12 hours,the NRS scores were significantly lower in group E when compared with group B at rest or coughing(P<0.05).No difference was observed in either group for NRS scores at 1 hours and 24 hours after surgery.Additionally,the costs of dizosin were much lower in group E.The patients in group B showed higher incidence of post-operative emesis.Conclusion The ultrasound-guided ESP block is more effective and safety than intercostal block for patients undergoing video-assisted radical lung cancer resection.
出处
《浙江临床医学》
2020年第1期129-130,共2页
Zhejiang Clinical Medical Journal
基金
浙江省自然科学基金资助项目(LQ18H310003)。
关键词
超声引导
竖脊肌平面阻滞
肺癌根治术
术后镇痛
Ultrasound guided
Erector spinae plane block
Radical lung cancer resection
Postoperative analgesia
作者简介
通信作者:汪俊恺。
