术中肋间神经阻滞联合术后静脉使用镇痛泵对开胸术后镇痛效果的观察  

Observation of analgesic effect of intercostal nerve blockade combined with patient-controlled intravenous analgesia after thoracic surgery

作　　者：马跃峰[1] 邢鑫[1] 马震川 孔冉冉[1] 孙良璋[1] 乔哲[1] 李少民[1] MA Yuefeng;XING Xin;MA Zhenchuan(Department of Thoracic Surgery,the Second Affiliated Hospital of Medical College of Xi＇an Jiaotong University,Xi＇an 710004,China)

机构地区：[1]西安交通大学第二附属医院胸外科,710004

出　　处：《临床外科杂志》2018年第9期686-688,共3页Journal of Clinical Surgery

摘　　要：目的探讨术中行肋间神经阻滞联合术后静脉使用镇痛泵对开胸术后镇痛的效果。方法行开胸手术的病人42例,随机分为两组,镇痛泵组(A组) 20例,肋间神经阻滞联合术后镇痛泵组(B组) 22例。比较两组病人术后静止、活动、咳嗽状态下的疼痛视觉模拟评分(visual analogue scale,VAS)、辅助使用止痛药次数及不良反应发生情况。结果 B组在静息、活动、咳嗽状态下的VAS总评分为(16. 43±0. 36)分,辅助止痛药使用率为45. 5%,A组分别为(27. 89±0. 45)分和55. 0%,两组比较差异有统计学意义(P <0. 05)。B组病人不良反应发生率为31. 8%,A组为65. 0%,两组比较差异无统计学意义(P> 0. 05)。结论术中肋间神经阻滞与术后静脉使用镇痛泵联合应用对开胸术后病人镇痛效果良好,安全性好,但不能缓解恶心、呕吐、嗜睡等不良反应。Objective To investigate the postoperative analgesic effect after thoracic surgery by intercostal nerve blockade combined with patient-controlled intravenous analgesia. Methods 42 patients after thoracotomy were randomly divided into the patient-controlled intravenous analgesia group（ group A）and intercostal nerve block combined patient-controlled intravenous analgesia group（ group B）. The use of intravenous analgesic drug pump was reduced in early postoperative period. All patients were comparatively observed with pain visual analogue scale（ visual analogue scale,VAS） in static condition,activity,cough,times of painkillers using and the incidence of adverse reactions. Result The VAS scores in static condition,activity,cough,times of painkillers using in group B[（ 16. 43 ± 0. 36）,45. 5%]was lower than group A[（ 27. 89 ± 0. 45）,55. 0%]there was statistical difference（ P〈0. 05）. There was no significant difference between group A（ 65. 0%） and group B（ 31. 8%） with incidence of adverse reactions（ P〉0. 05）. Conclusion The combination of intercostal nerve blockade and postoperative patient-controlled intravenous analgesia has a good analgesic effect and safety for postoperative patients after thoracotomy,but can not relieve the adverse reactions such as nausea,vomiting and drowsiness.

关 键 词：肋间神经阻滞 镇痛泵 开胸术 联合镇痛 

分 类 号：R614[医药卫生—麻醉学]