超声引导下肋间神经阻滞在单侧乳房肿块切除术中的应用  

The effect of the ultrasound-guided intercostal nerve block in the unilateral lumpectomy

作　　者：王韦玮[1] 周卫东[1] 王玺[1] 

机构地区：[1]江苏省昆山市第二人民医院麻醉科,215300

出　　处：《临床麻醉学杂志》2015年第8期763-765,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察超声引导下肋间神经阻滞在单侧乳房肿块切除术中的应用效果。方法60例择期拟行单侧乳房肿块切除术女性患者,年龄19~42岁,BMI 17.9~26.8kg/m2,随机分为超声引导组（U组）和传统定位组（N组）,均行肋间神经阻滞,局麻药均为0.25%左旋布比卡因20ml。观察阻滞操作时间,阻滞起效时间,阻滞完善时间,手术开始切皮时VAS评分,镇痛维持时间,手术中牵拉深部组织时VAS评分,镇痛不全和局麻药中毒情况。结果 与N组比较,U组操作时间明显延长,阻滞起效时间明显缩短,手术开始切皮时VAS评分明显降低,阻滞完善时间明显缩短,镇痛维持时间明显延长,术中牵拉深部组织时VAS评分明显降低,镇痛不全及麻醉后出现头晕明显减少（P〈0.05）。两组均未出现恶心呕吐症状。结论 超声引导下肋间神经阻滞在单侧乳房肿块切除术中的麻醉效果明显优于传统定位。Objective To observe the effect of the ultrasound-guided intercostal nerve block in the unilateral lumpectomy. Methods Sixty female patients aged 19-42 years scheduled for unilateral lumpectomy, BMI 17.9-26.8 kg/m2, ASA Ⅰ or Ⅱ , were randomly divided into two groups, the ultrasound-guided group （group U） and the conventional positioning group （group N）, and were given intercostal anesthesia, using 20 ml of 0. 25G levobupivacaine in both groups. The time for the anesthe- sia procedure, for the anesthetic to take effect and for the anesthesia to complete, the VAS on skin incision, the duration of action, the VAS during the retraction of deep tissues, and the occurrence of incomplete analgesia and local anesthetic toxicity were observed. Results Group U shows shorter time for the anesthetic to take effect and for the anesthesia to complete, longer time for anesthesia procedure and duration of action, lower VAS on skin incision and during deep tissue retraction than the group N （P〈0.05）. There were 3 cases of incomplete analgesia and 2 cases of dizziness after anesthesia in group N, and none in group U. Conclusion Ultrasound guided intercostal nerve block could provide better anesthesia effect conventional positioning.

关 键 词：超声引导 肋间神经阻滞 安全性 时效性 

分 类 号：R614[医药卫生—麻醉学]