亚甲蓝 左旋布比卡因混合液肋间神经阻滞用于开胸术后镇痛的观察  

The effect of intercostal nerve block with methylene blue and levobupivacaine on postoperative analgesia after thoracotomy

作　　者：曹鑫[1] 黄际红 张彦斌 钟信明 Cao Xin;Huang Jihong;Zhang Yanbin(The People's Hospital of Xinfeng, Xinfeng,Jiangxi 341600)

机构地区：[1]信丰县人民医院,江西信丰341600

出　　处：《基层医学论坛》2019年第10期1333-1334,共2页The Medical Forum

基　　金：赣州市指导性科技计划项目(GZ2017ZSF429)

摘　　要：目的探讨亚甲蓝、左旋布比卡因混合液肋间神经阻滞在开胸术后镇痛中的应用价值。方法择选2017年4月—2018年4月于我院行开胸手术的患者48例,随机分为观察组(n=24)及对照组(n=24)。对照组应用术后静脉镇痛泵,观察组则在对照组的基础上于开胸手术关闭胸腔时应用亚甲蓝、左旋布比卡因混合液进行肋间神经阻滞。对2组术后呼吸循环情况、疼痛程度及并发症发生率进行对比。结果观察组术后MAP、CVP、HR及疼痛VAS评分均低于对照组(P<0.05);观察组术后并发症发生率为16.67%,低于对照组的45.83%(P<0.05)。结论开胸手术患者在常规静脉镇痛泵的基础上辅以亚甲蓝、左旋布比卡因混合液肋间神经阻滞实施术后镇痛,可有效降低疼痛感受和并发症发生率,保持术后循环、呼吸稳定,临床应用价值显著。Objective To investigate the application value of intercostal nerve block with methylene blue and levobupivacaine mixture in analgesia after thoracotomy.Methods 48 patients who underwent thoracotomy from April 2017 to April 2018 were randomly divided into observation group (n = 24) and control group (n = 24). The control group was given intravenous analgesia pump after operation, while the observation group was given intercostal nerve block with methylene blue and levobupivacaine mixture when thoracotomy was performed on the basis of the control group. Respiratory and circulatory conditions,pain degree and complication rate were compared between the two groups. Results The scores of MAP,CVP,HR and pain VAS in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was 16.67%,which was lower than 45.83% in the control group (P<0.05).Conclusion Intravenous analgesic pump combined with methylene blue and levobupivacaine mixed liquid intercostal nerve block can effectively reduce the incidence of pain and complications,maintain stable circulation and breathing after thoracotomy,and has significant clinical value.

关 键 词：开胸手术 术后镇痛 亚甲蓝 左旋布比卡因 肋间神经阻滞 

分 类 号：R655[医药卫生—外科学]