B超引导胸椎旁神经阻滞对老年患者胸腔镜肺癌根治术麻醉效果的影响  

Effect of B-ultrasound Guided Thoracic Paraspinal Nerve Block on Anesthetic Effect of Thoracoscopic Radical Resection of Lung Cancer in Elderly Patients

作　　者：张斌 陈永红 厉传艺 宋炳炎 夏晴 ZHANG Bin;CHEN Yonghong;LI Chuanyi;SONG Bingyan;XIA Qing(Nantong Sixth People’s Hospital,Nantong 226011,China)

机构地区：[1]南通市第六人民医院,江苏南通226011

出　　处：《中外医学研究》2022年第1期4-7,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：南通市市级科技计划(指导性)立项项目(MSZ20129)。

摘　　要：目的:研究老年患者胸腔镜肺癌根治术中应用B超引导胸椎旁神经阻滞的麻醉效果。方法:选择2019年2月-2021年2月在南通市第六人民医院行胸腔镜下肺癌根治术的老年患者100例,最终纳入研究94例,按麻醉方式的不同分为对照组和试验组,试验组(n=46)采取B超引导下胸椎旁神经阻滞麻醉联合全身麻醉;对照组(n=48)采取单纯全身麻醉。分别记录试验组和对照组患者心率及血压变化,对比术中及术后镇痛药物的使用情况。对术后患者2、12、24、48 h VAS评分、舒适度及镇静评分情况进行比较。结果:试验组患者术中心率、血压增加均明显少于对照组(P<0.01)。试验组患者术中镇痛药物用量明显少于对照组(P<0.05)。术后24、48 h内,试验组患者术后静脉自控泵按压次数明显少于对照组(P<0.05);试验组术后卧床、活动2、12、24、48 h的VAS评分均低于对照组(P<0.05);试验组术后1、2 h舒适度评分高于对照组,镇静评分低于对照组(P<0.05)。结论:在胸腔镜肺癌根治术中应用B超引导下胸椎旁神经阻滞麻醉能够减少镇痛药物用量,获得良好的镇痛效果,并提高患者的舒适度。Objective:To study the anesthetic effect of B-ultrasound guided thoracic paraspinal nerve block in elderly patients undergoing thoracoscopic radical resection of lung cancer.Method:A total of 100 elderly patients who underwent thoracoscopic radical resection for lung cancer in Nantong Sixth People’s Hospital from February 2019 to February 2021 were selected,and 94 patients were finally included.According to the anesthesia method,they were divided into experimental group and control group.The experimental group (n=46) received B-ultrasound guided thoracic paravertebral nerve block anesthesia combined with general anesthesia.The control group (n=48) received general anesthesia.The changes of heart rate and blood pressure in the experimental group and the control group were recorded,and the use of analgesics during and after operation were compared.The VAS scores,comfort degree and sedation scores were compared at 2,12,24 and 48 h after operation.Result:The increase of heart rate and blood pressure of operation in the experimental group were significantly less than those in the control group (P<0.01).Compared with the control group,the amount of analgesics use in the experimental group was significantly less (P<0.05).The pressing of the patient-control intravenous analgesia pump in the experimental group were less than those in the control within 24 h and 48 h after the operation (P<0.05).The VAS scores of the experimental group at 2,12,24 and 48 h after operation of in bed and active were lower than those of the control group (P<0.05).The comfort degree in the experimental group at 1 and 2 h after operation were higher than those in the control group,and the sedation scores were lower than those in the control group (P<0.05).Conclusion:The application of B-ultrasound guided thoracic paravertebral nerve block anesthesia in thoracoscopic radical surgery for lung cancer can reduce the amount of analgesic drugs,obtain good analgesic effect and improve the patients’ comfort.

关 键 词：胸椎旁神经阻滞 胸腔镜手术 B超引导 镇痛药物使用 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]