摘要
目的:探讨B超引导下胸椎旁神经阻滞对胸腔镜肺癌根治术患者术后镇痛效果的影响。方法:根据麻醉方法的不同将100例接受胸腔镜肺癌根治术的患者分为椎旁神经阻滞组和常规麻醉组,每组50例患者。对常规麻醉组患者进行单纯全身麻醉,对椎旁神经阻滞组患者进行全身麻醉复合胸椎旁神经阻滞。然后比较两组患者的各项临床指标。结果:1)在T_(3)、T_(4),椎旁神经阻滞组患者的心率和平均动脉压均明显低于常规麻醉组患者,差异有统计学意义(P<0.05)。2)在术后2 h、12 h、24 h、48 h,椎旁神经阻滞组患者的静态VAS评分、动态VAS评分均明显低于常规麻醉组患者,差异有统计学意义(P<0.05)。3)在术后48 h内,椎旁神经阻滞组患者的静脉自控镇痛泵按压次数、镇痛药物的总输注量均明显少于常规麻醉组患者,差异有统计学意义(P<0.05)。4)椎旁神经阻滞组患者的苏醒室停留时间、术后拔管的时间、术后首次下床活动的时间、住院时间均明显短于常规麻醉组患者,差异有统计学意义(P<0.05)。5)椎旁神经阻滞组患者麻醉不良反应的发生率明显低于常规麻醉组患者,差异有统计学意义(P<0.05)。结论:将胸椎旁神经阻滞应用于胸腔镜肺癌根治术中可显著提高患者术后的镇痛效果,降低其麻醉不良反应的发生率。
Objective:To investigate the effect of thoracic paravertebral nerve block guided by B ultrasound on postoperative analgesia in patients with thoracoscopic radical resection of lung cancer.Methods:According to different anesthesia methods,100 patients receiving thoracoscopic radical resection of lung cancer were divided into paravertebral nerve block group and conventional anesthesia group,50 patients in each group.Patients in the conventional anesthesia group were given general anesthesia alone,and patients in the paravertebral nerve block group were given general anesthesia combined with thoracic paravertebral nerve block.Then the clinical indicators of the two groups were compared.Results:1)At T3 and T4,the heart rate and mean arterial pressure in the paravertebral nerve block group were significantly lower than those in the conventional anesthesia group,with statistical significance(P<0.05).2)At 2 h,12 h,24 h and 48 h after surgery,the static VAS score and dynamic VAS score in the paravertebral nerve block group were significantly lower than those in the conventional anesthesia group,with statistically significant differences(P<0.05).3)Within 48 h after surgery,The Times of intravenous self-controlled analgesic pump pressure and the total amount of analgesic drugs in the paravertebral nerve block group were significantly lower than those in the conventional anesthesia group,with statistical significance(P<0.05).4)The stay time in the wake room,the time of postoperative extubation,the time of first postoperative ambulation and the length of hospital stay in the paraspinal nerve block group were significantly shorter than those in the conventional anesthesia group,with statistical significance(P<0.05).5)The incidence of adr in paravertebral nerve block group was significantly lower than that in conventional anesthesia group,with statistical significance(P<0.05).Conclusion:The application of thoracic paravertebral nerve block in thoracoscopic radical resection of lung cancer can significantly improve postoperative analgesia effect and reduce the incidence of adverse anesthetic reactions.
作者
李洪涛
LI Hongtao(Department of Anesthesiology,Chenzhou First People’s Hospital,Chenzhou Hunan 423000)
关键词
胸腔镜
肺癌根治术
全身麻醉
胸椎旁神经阻滞
术后镇痛
thoracoscopy
Radical resection of lung cancer
General anesthesia
Thoracic paravertebral nerve block
Postoperative analgesia
作者简介
李洪涛,副主任医师,E-mail:190701496@qq.com。
