肋间神经阻滞联合盐酸羟考酮超前镇痛在胸腔镜肺叶切除术中的观察应用  

Observation Application of Preemptive Analgesia with Intercostal Nerve Blocking Combined with Oxycodone Hydrochloride in Thoracoscopic Surgery of Pulmonary Lobectomy

作　　者：郝晓燕[1] 王群超[1] 赵华国[1] 

机构地区：[1]辽宁省大连市友谊医院,大连116001

出　　处：《航空航天医学杂志》2016年第10期1214-1217,共4页Journal of Aerospace medicine

摘　　要：目的研究肋间神经阻滞联合盐酸羟考酮超前镇痛在胸腔镜肺叶切除术的应用效果。方法 2014年11月-2015年11月择期进行胸腔镜肺叶切除术患者60例,随机分为两组,实验组和对照组。实验组在麻醉后切皮前于超声引导下行肋间神经阻滞和手术结束前给予盐酸羟考酮0.1 mg/kg静脉推注;对照组于手术结束前给予芬太尼1μg/kg静脉推注。分别记录麻醉诱导前(T0)、手术结束时(T1)、拔管时(T2)、拔管后30 min(T3)、拔管后2 h(T4)、拔管后4 h(T5)的血压、心率、脉氧饱和度及两组患者的呼吸恢复时间,睁眼时间及气管导管的拔出时间,以及两组患者恶心呕吐等不良反应的发生率。评价患者于T3、T4、T5时视觉模拟评分(VAS)。结果对照组呼吸恢复时间、睁眼时间和气管导管拔出时间明显较实验组长,差异有显著性。两组患者在T0、T1时SBP、DBP、HR无统计学意义,T2到T5对照组SBP、DBP、HR明显升高,和实验组有显著差异;T3到T5时实验组患者的VAS评分明显低于对照组,差异有显著性。结论肋间神经阻滞联合盐酸羟考酮超前镇痛可以有效的防止胸腔镜肺叶切除术引起的术后疼痛,减少不良反应的发生。Objective To study the application effect of preemptive analgesia with intercostal nerve blocking combined with oxycodone hydrochloride in thoracoscopic surgery of pulmonary lobectomy. Methods Our hospital selected60 cases of patients to undergo thoracoscopic surgery of pulmonary lobectomy from November 2014 to November 2015 and randomly divided them into two groups： experimental group and control group. The experimental group was treated with intercostal nerve blocking under ultrasonic guidance after anesthesia and before skin incision and intravenous injection of 0. 1 mg / kg oxycodone hydrochloride before ending of the surgery. The control group was treated with intravenous injection of 1 μg / kg remifentanil before ending of the surgery. Following items were recorded at various timings like before the anesthesia induction（ T0）,at the ending of surgery（ T1）,at the time of extubation（ T2）,within thirty minutes after extubation（ T3）,two hours after extubation（ T4） and four hours after extubation（ T5）,respectively,including two groups of patients＇ blood pressure,heart rate,Sp O2,the time of respiration recovery,the eye opening time,the extubation time of endotracheal tube and the occurrence rate of adverse reactions like nausea and vomiting.The patients＇ Visual Analogue Score（ VAS） at T3,T4 and T5 were evaluated. Results The control group＇s respiration recovery time,the eye opening time and the extubation time of endotracheal tube were obviously longer than that of the experimental group,presenting significant difference. There was no statistical significance in terms of SBP,DBP and HR at T0 and T1 for two groups of patients. SBP,DBP and HR of the control group significantly rose at T2 to T5,which was obviously different from that of the experimental group. VAS of the experimental group at T3 to T5 were significantly lower than that of the control group,with the difference being significant. Conclusions Preemptive analgesia with intercostal nerve blocking combined with oxycodo

关 键 词：肋间神经阻滞 盐酸羟考酮 超前镇痛 胸腔镜肺叶切除术 

分 类 号：R614.4[医药卫生—麻醉学]