肋间神经阻滞联合患者自控静脉镇痛预防开胸术后全身麻醉苏醒期躁动的效果观察  

Effect of Preventing Restlessness by Intercostal Nerve Block Combinded PCIA During General Anesthesia Recover Post Thoracotomy

作　　者：刘桂颖 

机构地区：[1]吉林省柳河县医院麻醉科,吉林柳河135300

出　　处：《中国医药指南》2014年第12期34-36,共3页Guide of China Medicine

摘　　要：目的：观察肋间神经阻滞联合患者自控静脉镇痛对开胸术后全麻苏醒期躁动的预防效果。方法择期开胸手术患者40例，均按相同麻醉方法进行麻醉：诱导用咪达唑仑2 mg、舒芬太尼30μg、丙泊酚1.5 mg/kg、苯磺酸顺式阿曲库铵0.15 mg/kg。麻醉维持用1%～2%七氟烷吸入、丙泊酚2～3 mg/（kg·h）、瑞芬太尼0.1～0.3μg/（kg·h）泵注，术毕随机分成对照组（A组，20例，即单纯患者自控静脉镇痛组）和实验组（B组，20例，即肋间神经阻滞＋患者自控静脉镇痛组）。记录并比较各组患者性别、年龄、体质量和手术种类，观察各组患者术后苏醒期躁动发生情况，比较两组间躁动发生例数及躁动程度。结果两组患者的年龄、性别、体质量及手术种类差异均无统计学意义（P＞0.05）；B组苏醒期躁动发生率与A组比较差异有统计学意义， A组明显少于B组（P＜0.05）。结论肋间神经阻滞及术后联合患者自控静脉镇痛可明显减少开胸术后患者全麻苏醒期躁动的发生。Objective To observe the effect of preventing restlessness by intercostal nerve block combined PCIA during general anesthesia recover post thoracotomy. Methods 40 selected patients were divided randomly into groupA（n=20, control group, only PCIA）, groupB（n=20, experimental group, intercostal nerve block＋PCIA）after operation.The same anesthesia induction and maintenance in two groups. Induction：Intravenous midazolam 2mg, sufentanil 30μg, propofol 1.5mg/kg and cisatracurium0.15mg/kg;maintenance：inhalated 1%-2%sevoflurane, intravenous propofol 2-3mg/（kg？h）and remifentanail 0.1-0.3μg/（kg？h）. To observe and record the patient’s sex, age, weight and types of operation;To observe the patient’s restlessness during general anesthesia recover after operation. To compare the cases of restlessness and restless degree between two groups. Results There were no significant difference between two groups of age, weight, sex and types of operation（P＆gt;0.05）;As compared with groupA, there was obviously difference of restlessness in groupB（P＆lt;0.05）. Conclusion The method of intercostal nerve block combined PCIA can decrease risk of restlessness during general anesthesia recover post thoracotomy.

关 键 词：开胸手术 肋间神经阻滞 全身麻醉 躁动 

分 类 号：R614.2[医药卫生—麻醉学]