开胸术后应用椎旁阻滞镇痛的临床研究  

The study of analgesic effect of paravertebral block after thoracic surgery

作　　者：付强[1] 郑传东[1] 

机构地区：[1]成都市第三人民医院麻醉科,四川成都610031

出　　处：《实用医院临床杂志》2012年第4期107-108,共2页Practical Journal of Clinical Medicine

摘　　要：目的观察椎旁阻滞镇痛在开胸术后的镇痛效果。方法选择单侧开胸患者90例,按随机数字表法分成静脉镇痛组(Ⅰ组)、硬膜外镇痛组(Ⅱ组)和椎旁阻滞镇痛组(Ⅲ组)各30例。三组患者均在全麻下完成手术,麻醉诱导前I组不作任何处理,Ⅱ、Ⅲ组分别行硬膜外和椎旁间隙穿刺置管。三组均使用术后自控镇痛,采用视觉模拟评分(visual analogue scale,VAS)评价术后镇痛质量,并观察并发症发生情况。结果Ⅱ、Ⅲ组术后6、12、24、48小时的VAS评分及镇痛泵按压次数均明显低于I组(P<0.05);Ⅲ组患者术后并发症明显少于Ⅰ、Ⅱ组(P<0.05)。结论在开胸手术中,硬膜外镇痛和椎旁阻滞镇痛效果优于静脉镇痛,但椎旁阻滞操作安全简便,并发症少,更适合单侧开胸术后镇痛治疗。Objective To evaluate the postoperative analgesic effect of paravertebral block after thoracic surgeries. Methods 90 patients undergoing thoracotomy were randomly divided into 3 groups ： intravenous analgesia group （ I）, epidural analgesia group （II） and paravertebral block analgesia group （III）. Epidural or paravertebral indwelling catheters were respectively placed for postoperative analgesia in group II or III prior to anesthesia. Patient-controlled analgesia （ PCA ） was adopted in all 3 groups. The effect of the postoperative analgesia was evaluated by the Visual analogue scale （VAS）. The complications were observed. Results The postoperative 6, 12,24,48 h VAS score in group II and III were significantly lower than group I （P 〈 0. 05）. The complications in group III were less than group I and II. Conclusion In the thoracic surgery,the effect of paravertebral block analgesia and epidural analgesia were better than intravenous analgesia. Garavertebral block analgesia was convenient and safe but with less complications.

关 键 词：椎旁阻滞 开胸手术 术后镇痛 

分 类 号：R441.4[医药卫生—诊断学] R614.41[医药卫生—临床医学]