超声引导胸椎旁神经阻滞在胸腔镜肺叶切除手术围术期的应用效果  

Perioperative Effect of Ultrasound-Guided Thoracic Paravertebral Nerve Block in Patients Undergoing Thoracoscopic Lobectomy

作　　者：刘艳军[1] 曾萍[1] 汪姝君 张博 彭薇 Liu Yanjun;Zeng ping;Wang Shujun;Zhang Bo;Peng Wei(Department of Anesthesiology,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University&Institute of Anesthesia and Perioperative Medicine,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]麻醉科&三峡大学麻醉与围术期医学研究所,湖北宜昌443003

出　　处：《巴楚医学》2021年第4期65-69,共5页Bachu Medical Journal

基　　金：湖北陈孝平科技发展基金(No:CXPJJH118000017-02-07);宜昌市医疗卫生科研项目(No:A14-30323)。

摘　　要：目的:评估超声引导胸椎旁神经阻滞(TPVB)复合全身麻醉在胸腔镜肺叶切除手术围术期的应用效果。方法:择期行胸腔镜肺叶切除术患者60例,按数字表法随机分为TPVB联合全麻组(GT组)和单纯全麻组(G组),每组30例。结果:GT组术中麻醉药物用量明显减少(P<0.05);苏醒时间、拔管时间、麻醉恢复室停留时间明显少于G组(均P<0.05)。GT组术后1 h、6 h静息时和1 h、6 h、12 h咳嗽时视觉模拟评分(VAS)均低于G组(均P<0.05);与G组比较,GT组术后镇静躁动评分(SAS)和术后48 h内镇痛泵有效按压次数明显减少(均P<0.05)。结论:超声引导TPVB联合全身麻醉用于胸腔镜肺叶切除术,围术期镇痛效果确切,阿片类镇痛药物用量减少,术后苏醒质量高,值得推广应用。Objective:To evaluate the effect of ultrasound-guided thoracic paravertebral nerve block(TPVB)combined with general anesthesia in patients undergoing thoracoscopic lobectomy.Methods:Sixty patients underwent elective thoracoscopic lobectomy were divided into the TPVB combined with general anesthesia group(GT group)and single general anesthesia group(G group)by random number table method,with 30 cases in each group.Results:Compared to the G group,the dosage of anaesthetics decreased significantly,and wake-up time,extubation time,residence time in anesthesia recovery room were significantly shorten in the GT group(all P<0.05).The visual analogue scale(VAS)score at 1 h and 6 h of rest,as well as 1 h,6 h and 12 h of cough in the GT group were all lower than those of G group(all P<0.05).Compared with the G group,the postoperative sedation-agitation score(SAS)and the effective pressing times of analgesic pump were both decreased considerably in the GT group within 48 h after operation(both P<0.05).Conclusion:Ultrasound-guided TPVB combined with general anesthesia used in thoracoscopic lobectomy could have accurate effect of perioperative analgesia and high quality of postoperative recovery,with reduction of opioid analgesics dosage,which is worthy of clinical application.

关 键 词：超声引导胸椎旁神经阻滞 苏醒质量 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]