超声引导下膈神经阻滞对腹腔镜胆囊切除术患者镇痛质量的影响  

The effect of ultrasound-guided phrenic nerve block on analgesic efficacy after laparoscopic cholecystectomy

作　　者：余焱 王萍 胡安民 海超 李丹 YU Yan;WANG Ping;HU An-min(Shenzhen People's Hospital,Shenzhen 518020,Guangdong)

机构地区：[1]深圳市人民医院,广东深圳518020

出　　处：《安徽卫生职业技术学院学报》2021年第3期47-49,共3页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:探讨超声引导下膈神经阻滞对腹腔镜胆囊切除术(LC)患者术后镇痛质量的影响。方法:拟行腹腔镜胆囊切除术的患者60例,随机分为对照组和试验组,每组30例。试验组患者使用0.2%罗哌卡因行右膈神经阻滞,对照组使用同等剂量生理盐水。记录术中瑞芬太尼和七氟烷用量、术中高血压和心动过速的发生率,采用视觉模拟评分(VAS),对术后4、8、12 h、24 h的疼痛程度进行评分。结果:与对照组相比,试验组患者术中瑞芬太尼和七氟烷用量和术中高血压发生率低(P<0.05),术后4 h、8 h、12 hVAS评分低(P<0.05),术后24 h舒芬太尼用量少(P<0.05)。对照组患者术后肩痛和术后恶心呕吐发生率高于试验组(P<0.05)。结论:0.2%罗哌卡因超声引导下右膈神经阻滞用于LC,可减少术中瑞芬太尼和七氟烷用量,降低术中高血压发生率,提高术后镇痛质量,减少术后镇痛药物使用,降低术后肩痛和术后恶心呕吐的发生率。Objective:To observe the effect of phrenic nerve block guided by ultrasound on postoperative analgesia quality of patients undergoing laparoscopic cholecystectomy(LC).Methods:Sixty patients undergoing laparoscopic cholecystectomy were randomly divided into control group and experimental group,with 30 cases in each group.The experimental group received 0.2%ropivacaine for right phrenic nerve block,while the control group received the same dose of normal saline.The dosage of remifentanil and sevoflurane,the incidence of hypertension and tachycardia during operation were recorded,and the pain degree was scored by visual analogue scale(VAS)at 4,8,12 and 24 hours after operation.Results:Compared with the control group,the dosage of remifentanil and sevoflurane during operation and the incidence of hypertension during operation in the experimental group were lower(P<0.05),the 12hVAS scores were lower at 4 h,8 h and 12 h after operation(P<0.05),and the dosage of sufentanil was less at 24h after operation(P<0.05).The incidence of postoperative shoulder pain and nausea and vomiting in the control group was higher than that in the experimental group(P<0.05).Conclusion:0.2%ropivacaine ultrasound-guided right phrenic nerve block for LC can reduce the dosage of fentanyl and sevoflurane during operation,reduce the incidence of hypertension during operation,improve the quality of postoperative analgesia,reduce the use of postoperative analgesic drugs,and reduce the incidence of postoperative shoulder pain and postoperative nausea and vomiting.

关 键 词：膈神经阻滞 腹腔镜胆囊切除术 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]