胸椎旁入路神经阻滞复合全身麻醉对微创肺癌根治术患者镇痛效果及血流动力学的影响  

Effect of thoracic paravertebral block combined with general anesthesia on the analgesia and hemodynamics of patients undergoing minimally invasive radical resection of lung cancer

作　　者：林琳[1] 刘立鹏 马松梅[1] LIN Lin;LIU Lipeng;MA Songmei(Department of Anesthesiology,the First People’s Hospital of Shangqiu,Shangqiu 476100,He’nan,China)

机构地区：[1]商丘市第一人民医院麻醉科,河南商丘4761000

出　　处：《癌症进展》2021年第14期1485-1488,共4页Oncology Progress

摘　　要：目的探讨胸椎旁入路神经阻滞复合全身麻醉对微创肺癌根治术患者镇痛效果及血流动力学的影响。方法采用随机数字表法将123例肺癌患者随机分为对照组(n=60)和研究组(n=63),对照组患者胸腔镜肺癌根治术中给予全身麻醉,研究组患者术中给予胸椎旁入路神经阻滞复合全身麻醉。比较两组患者的麻醉效果、血流动力学指标、疼痛程度和不良反应发生情况。结果研究组患者术中瑞芬太尼使用量、术中丙泊酚使用量、术后舒芬太尼使用量、术后镇痛泵按压次数均明显低于对照组(P﹤0.01)。麻醉诱导后30 min,两组患者收缩压、舒张压均低于本组麻醉诱导前(P﹤0.05),且研究组患者收缩压、舒张压均低于对照组(P﹤0.05);术后6 h,两组患者收缩压、舒张压及心率均低于本组麻醉诱导前(P﹤0.05),且研究组患者收缩压、舒张压及心率均低于对照组(P﹤0.05)。术后2、24、48 h,研究组患者的视觉模拟评分法(VAS)评分均明显低于对照组(P﹤0.01)。研究组不良反应总发生率为11.11%,明显低于对照组的40.00%(P﹤0.01)。结论胸椎旁入路神经阻滞麻醉可有效降低微创肺癌根治术患者术中及术后麻醉药物的使用剂量,镇痛效果较好,且可减轻疼痛程度,改善血流动力学指标,降低术后不良反应发生率。Objective To investigate the effect of thoracic paravertebral block combined with general anesthesia on the analgesia and hemodynamics of patients undergoing minimally invasive radical resection of lung cancer.Method A total of 123 patients with lung cancer were randomly divided into control group(n=60)and study group(n=63)using a random number table method.The control group was given general anesthesia during thoracoscopic radical resection of lung cancer,and the study group was assigned with the thoracic paravertebral block combined with general anesthesia.The anesthesia effect,hemodynamic indicators,pain degree,and the occurrence of adverse events were compared be-tween the two groups of patients.Result The amount of remifentanil used in the study group,the amount of propofol used during the operation,the amount of sufentanil used after the operation,and the number of times of postoperative an-algesic pump compressions were all lower than those in the control group(P<0.01).Thirty minutes after induction of an-esthesia,the systolic and diastolic blood pressures of the two groups were lower than before the induction(P<0.05),and the systolic and diastolic blood pressures of the study group were lower than those of the control group(P<0.05).At 6 hours after the operation,the systolic blood pressure,diastolic blood pressure,and heart rate of the two groups were lower than before the induction of anesthesia(P<0.05),the systolic blood pressure,diastolic blood pressure,and heart rate of the study group were lower than those of the control group(P<0.05).At 2,24,and 48 h after the operation,the visual ana-logue scale(VAS)scores of the study group were lower than those of the control group(P<0.01).The study group’s total incidence of adverse events was 11.11%,significantly lower than the 40.00%in the control group(P<0.01).Conclusion The thoracic paravertebral block could effectively reduce the usage of anesthetic drugs during and after minimally inva-sive radical resection of lung cancer.Besides,this method would achie

关 键 词：胸椎旁入路 神经阻滞麻醉 微创 肺癌根治术 镇痛 血流动力学 

分 类 号：R734.2[医药卫生—肿瘤]