不同神经阻滞用于胸腔镜术后镇痛效果对比研究  

Observation of clinical effect of nerve block surgery for analgesia after thoracotomy

作　　者：宋华杰 杨鲲鹏[1] 张进[1] 葛晓晴[1] 侯露[1] Song Huajie;Yang Kunpeng;Zhang Jin;Ge Xiaoqing;Hou Lu(Department of Thoracic surgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou,450014,China)

机构地区：[1]郑州大学第二附属医院胸外科,郑州450014

出　　处：《河南外科学杂志》2021年第4期23-25,共3页Henan Journal of Surgery

摘　　要：目的探讨不同神经阻滞用于胸腔镜术后镇痛的效果。方法前瞻性纳入2019-02—2020-01于郑州大学第二附属医院胸外科行胸腔镜手术的患者,术后均应用0.75%的罗哌卡因行神经阻滞镇痛。按照神经阻滞方法分为肋间神经阻滞(INB)联合胸椎旁神经阻滞(TPVB)组(A组)、INB组(B组)和TPVB组(C组)。比较3组患者的基线资料。参考视觉模拟评分法(VAS)评价术后8 h、24 h、36 h及48 h时点胸壁戳口疼痛程度。统计不良反应发生率。结果共纳入90例患者,每组30例。3组患者的基线资料差异无统计学意义(P>0.05)。A组各时点的VAS评分和持续镇痛时间(48 h)均优于B组、C组;而C组患者8~36 h时点的VAS评分和持续镇痛时间(36 h)均优于B组。差异均有统计学意义(P<0.05)。3组不良反应发生率差异无统计学意义(P>0.05)。结论INB联合TPVB用于胸腔镜术后镇痛,镇痛效果和持续时间均优于单独INB及TPVB,且未增加不良反应发生率,是一种安全、有效的镇痛方式。Objective To observe the clinical efficacy of nerve block surgery for postoperative analgesia in patients undergoing thoracic surgery and video-assisted thoracoscopy.Methods The Patients in the thoracic surgery were prospectively included from 2019-02 to 2020-01 in the Second Affiliated Hospital of Zhengzhou University underwent 0.75%postoperative ropivacaine with nerve block analgesia.They were divided into intercostal nerve block(INB)combined with parathoracic vertebral nerve block(TPVB)group(A),INB group(B)and TPVB group(C).Compare baseline data of 3 groups.Point chest wall puncture pain was evaluated by visual simulation scoring(VAS)(8 h,24 h,36 h and 48 h).Statistical incidence of adverse reactions.Results A total of 90 patients,each group 30 cases,and 3 baseline differences were not Statistically significant(P>0.05).VAS score and continuous analgesia(48 h)in A points were better in B and C;VAS score and 36 h at 8~36 h were better in B.The differences are all statistically significant(P<0.05).There was no statistical difference in the incidence of adverse reactions(P<0.05).Conclusion Intercostal nerve block combined with parathoracic nerve block can relieve postoperative pain more safely and long-term.It is a commendable joint analgesic method.

关 键 词：肋间神经阻滞术 胸椎旁神经阻滞术 术后镇痛 

分 类 号：R614.4[医药卫生—麻醉学]