胸椎旁阻滞用于肝脏肿瘤射频消融术中麻醉效果的评价  

The anesthetic effect of thoracic paravertebral block used in radiofrequency ablation of liver tumor

作　　者：邱良诚[1] 吴晓丹[1] 吴松松 陈佳莉 陈宇[1] 陈彦青[1] QIU Liang-cheng(Department of anesthesiology,Fujian provincial Jinshan hospital,provincial clinical medical college of Fujian Medical University,Fuzhou,Fujian,350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立金山医院麻醉科,福建福州350001 [2]福建医科大学省立临床医学院,福建省立医院超声科,福建福州350001

出　　处：《齐齐哈尔医学院学报》2020年第18期2302-2304,共3页Journal of Qiqihar Medical University

基　　金：福建省卫计委青年科研课题(2018-1-31)。

摘　　要：目的评价胸椎旁阻滞用于肝脏肿瘤射频消融术中的麻醉效果。方法选择2019年4月—2020年4月本院收治的拟肝肿瘤射频消融手术患者60例作为研究对象,年龄45~75岁,随机数表法分为胸椎旁阻滞组(T组)和局部浸润麻醉组(N组)两组,每组各30例。T组患者采用T7和T9椎旁阻滞,N组沿射频消融路径行局部浸润麻醉。两组患者采用视觉模拟量表(VAS)评估疼痛情况,并记录术中镇痛药物补救情况及患者和超声科医师对术中麻醉管理的满意度。结果 T组患者术中疼痛控制优于N组(P<0.05),舒芬太尼补救用量比较,N组明显高于T组(P<0.05),同时患者及超声科医师对术中麻醉管理效果满意度比较,T组明显优于N组(P<0.05)。结论与局部浸润麻醉比较,胸椎旁阻滞用于肝脏肿瘤射频消融手术可以减少阿片类药物使用,提高术中安全性,及患者和手术操作者的满意度。Objective To evaluate the anesthetic effect of thoracic paravertebral block used in radiofrequency ablation of liver tumors.Methods 60 cases of patients those will receive radiofrequency ablation of liver tumor during the period of April 2019 to April 2020 were enrolled as study subjects,agedfrom 45 to 75 years old,they were randomly divided into two groups:thoracic paravertebral block group( group T) and local infiltration anesthesia group(group N).Patients in group T received paravertebral block at T7 and T9,local infiltration anesthesia along the radiofrequency ablation path was adopted in Group N.Visual analog scale(VAS) was used to assess the pain situation in the two groups groups of patients.Intraoperative analgesic drug remedy,the satisfaction of patients andultrasound physician during the intraoperative anesthesia management were recorded.Results The intraoperative pain control of group T were better than group N(P<0.05).The rescue dosage of sulfentanyl in group N were significantly higher than group T(P<0.05).At the same time,the satisfaction of patients and ultrasound physician in the management of intraoperative anesthesia in group T were significantly better than that that in group N(P<0.05).Conclusions Compared with local infiltration anesthesia,thoracic paravertebral block for radiofrequency ablation of liver tumors could reduce the use of opioids,improve intraoperative safety,and satisfaction of patients and surgical operators.

关 键 词：胸椎旁阻滞 肝脏肿瘤 射频消融 

分 类 号：R653[医药卫生—外科学]