超声引导下竖脊肌平面阻滞联合纳布啡超前镇痛对肺癌手术患者术后镇痛的影响  

EFFECT OF ULTRAOUND-GUIDED SPINAL PLANAR BLOCK COMBINED WITH PREEMPTIVE ANALGESIA WITH NABUFEN ON POSTOPERATIVE ANALGESIA IN PATIENTS WITH LUNG CANCER

作　　者：翟浩宇 姚型柱 王莉[1] ZHAI Haoyu;YAO Xingzhu;WANG Li(Department of Anesthesiology,The First People's Hospital of Guangyuan,Guangyuan 628000 China)

机构地区：[1]四川省广元市第一人民医院麻醉科,628000

出　　处：《中国煤炭工业医学杂志》2021年第2期152-156,共5页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生厅科研课题(编号:20170713)。

摘　　要：目的分析超声引导下竖脊肌平面阻滞联合纳布啡超前镇痛对肺癌手术患者术后镇痛的影响。方法选取四川省广元市第一人民医院2018年8月—2019年8月收治的74例肺癌手术患者,根据不同麻醉方案将其分为A组(37例)与B组(37例),A组采用超声引导下竖脊肌平面阻滞,B组采用超声引导下竖脊肌平面阻滞联合纳布啡超前镇痛,比较二组患者的血流动力学(动脉压、心率)、炎性因子水平(肿瘤坏死因子-α、白细胞介素-6、白细胞介素-10)、心血管反应(高血压、心动过速)、术后疼痛程度(VAS评分)。结果二组的动脉压、心率对比,均P<0.05;其中在置管后、切片时、拔管后B组的动脉压、心率均优于A组(均P<0.05);二组的动脉压、心率均有随时间变化的势态(均P<0.05),分组与时间有交互效应。二组的肿瘤坏死因子-α、白细胞介素-6、白细胞介素-10比较,均P<0.05;其中在术后2、6、12h,B组的肿瘤坏死因子-α、白细胞介素-6、白细胞介素-10均低于A组(均P<0.05);二组的肿瘤坏死因子-α、白细胞介素-6、白细胞介素-10均有随时间变化的势态(均P<0.05),分组与时间有交互效应。B组心血管反应发生率(5.4%)低于A组(21.6%),均P<0.05。二组的术后VAS评分比较,均P<0.05;二组的术后VAS评分均有随时间变化的势态(均P<0.05),分组与时间有交互效应。结论超声引导下竖脊肌平面阻滞联合纳布啡超前镇痛对肺癌手术患者术后镇痛具有显著作用,且可稳定患者的血流动力学,改善抗炎因子水平,减轻炎性反应与心血管反应。Objective To analyze the effect of ultrasound-guided spinal planar block combined with preemptive analgesia with nabufen on postoperative analgesia in patients with lung cancer.Methods Seventy four patients with lung cancer who underwent operation in the first people’s Hospital of Guangyuan from August 2018 to August 2019 were selected.According to different anesthesia schemes,they were included in the control group(37 cases)and the observation group(37 cases).The control group was treated with ultrasound-guided plane block of the erector spine muscle,while the observation group was treated with ultrasound-guided plane blockof the erector spine muscle combined with preemptive analgesia with nabuphine.The hemodynamics(arterial pressure,heart rate),levels of inflammatory factors(tumor necrosis factor-alpha,interleukin-6,interleukin-10),cardiovascular response(hypertension,tachycardia)and postoperative pain(VAS score)were compared between the two groups.Results The arterial pressure and heart rate of the two groups were compared,P<0.05;the arterial pressure and heart rate of the observation group were better than those of the control group(P<0.05)after catheterization,section time and extubation;the arterial pressure and heart rate of the two groups changed with time(P<0.05).The results showed that the tumor necrosis factor-α,IL-6 and IL-10 in the two groups were compared,P<0.05,and the tumor necrosis factor-α,IL-6 and IL-10 were compared in the two groups,and the results were 2,6,12 hours after operation The tumor necrosis factor-α,IL-6 and IL-10 in group B were lower than that of group A(P<0.05).The potential of TNF-A,IL-6 and IL-10 in both groups were all changed with time(P<0.05).Interaction effect.The incidence of cardiovascular reaction in the observation group(5.4%)was lower than that in the control group(21.6%),(P<0.05).Postoperative VAS scores of the two groups were compared,P<0.05;VAS scores of the two groups changed with time(P<0.05),and there was an interaction between grouping and time.Conclusion U

关 键 词：超声引导下竖脊肌平面阻滞 纳布啡 超前镇痛 肺癌手术 术后镇痛 

分 类 号：R734[医药卫生—肿瘤]