对接受胸腔镜肺癌根治术的患者进行超声引导下菱形肌-肋间肌阻滞的效果探究  

To investigate the effect of ultrasound-guided rhomboid-intercostal muscle block in patients undergoing thoracoscopic radical resection of lung cancer

作　　者：刘奥 董希玮[1] 李燕[1] 于海[1] 葛明月 殷姜文 LIU Ao;DONG Xiwei;LI Yan;YU Hai;GE Mingyue;YIN Jiangwen(Department of Anesthesiology,the First Affiliated Hospital,School of Medicine,Shihezi University,Shihezi,Xinjiang 832008)

机构地区：[1]石河子大学医学院第一附属医院麻醉科,新疆石河子832008

出　　处：《当代医药论丛》2021年第14期34-38,共5页

基　　金：新疆维吾尔自治区石河子大学医学院第一附属医院重点基金资助项目(项目编号:ZD201906)。

摘　　要：目的:探讨并研究对接受胸腔镜肺癌根治术的患者进行超声引导下菱形肌-肋间肌阻滞(RIB)的效果。方法:选取在石河子大学医学院第一附属医院进行胸腔镜肺癌根治术的86例患者作为研究对象。随机将其分为观察组与对照组。术中对两组患者均进行全身麻醉,在麻醉诱导前对观察组患者进行单次RIB(所用药物为罗哌卡因),未对对照组患者进行RIB,术后对两组患者均进行静脉自控镇痛(PCIA),然后比较两组患者的各项临床指标。结果:观察组患者术中瑞芬太尼的输注量少于对照组患者,P<0.05。术后6 h、18 h及24 h,观察组患者静态和动态下的疼痛数字评分法(NRS)评分均低于对照组患者,P<0.05;观察组患者伯格曼舒适度量表(BCS)的评分均高于对照组患者,P<0.05。与对照组患者相比,观察组患者术后首次静脉推注酮咯酸氨丁三醇的时间更晚,术后48 h内静脉推注酮咯酸氨丁三醇的次数更少,其术后24 h内和48 h内PCIA的有效按压次数和酒石酸布托啡诺的用量均更少,P<0.05。用药后,两组患者恶心呕吐、便秘、皮肤瘙痒的发生率相比,P>0.05。结论:对接受胸腔镜肺癌根治术的患者进行超声引导下RIB能减少其术中及术后镇痛药物的用量,减轻其术后疼痛的程度,提高其术后的舒适度,且用药较为安全。Objective:To investigate the effect of ultrasound-guided rhomboid intercostal muscle block(RIB)in patients undergoing thoracoscopic radical resection of lung cancer.Methods:A total of 86 patients underwent thoracoscopic radical resection of lung cancer in the First Affiliated Hospital of Shihezi University Medical College were selected as the research subjects.They were randomly divided into observation group and control group.Patients in the observation group were given a single RIB(ropivacaine was used)before anesthesia induction,while patients in the control group were not given RIB.After surgery,patients in both groups were given intravenous controlled analgesia(PCIA),and then the clinical indicators of the two groups were compared.RESULTS:The amount of remifentanil infusion in observation group was less than control group(P<0.05).At 6,18 and 24 h after surgery,the static and dynamic pain digital scale(NRS)scores of observation group were lower than those of control group(P<0.05);The scores of Bergman Comfort Scale(BCS)in observation group were higher than those in control group(P<0.05).Compared with the control group,the first postoperative intravenous injection of ketorolac ambutamine was later in the observation group,and the number of intravenous injection of ketorolac ambutamine was less within 48 h after the operation,and the effective times of PCIA and the amount of butorphanol tartrate were less within 24 h and 48 h after the operation,all P<0.05.After medication,the incidence of nausea and vomiting,constipation and pruritus in 2 groups was compared with P BBB 0.05.Conclusion:Ultrasonic-guided RIB can reduce the amount of intraoperative and postoperative analgesic drugs,relieve the degree of postoperative pain and improve the postoperative comfort of patients undergoing thoracoscopic radical resection of lung cancer,and the drug use is relatively safe.

关 键 词：胸腔镜肺癌根治术 超声引导下菱形肌-肋间肌阻滞 静脉自控镇痛 不良反应 

分 类 号：R614.4[医药卫生—麻醉学]