围手术期疼痛管理联合肋间神经阻滞和切口周围浸润麻醉对胃癌手术期疼痛管理的优化作用分析  

Analysis of optimal effect of perioperative pain management combined with intercostal nerve block and peri-incision infiltration anesthesia on pain management during gastric cancer operation

作　　者：马晓楠 董蕊蕊[1] 史鹏许 MA Xiaonan;DONG Ruirui;SHI Pengxu(Department of Operation,Clinical Medical College of He’nan University of Science and Technology/the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471003,He’nan,China)

机构地区：[1]河南科技大学临床医学院/河南科技大学第一附属医院手术部,河南洛阳471003

出　　处：《癌症进展》2022年第17期1806-1809,共4页Oncology Progress

摘　　要：目的 观察围手术期疼痛管理联合肋间神经阻滞(ICNB)和切口周围浸润麻醉优化措施在胃癌手术患者中的应用效果。方法 将100例接受手术治疗的胃癌患者根据疼痛管理方式的不同分为传统疼痛管理组(50例)和疼痛管理优化组(50例),其中传统疼痛管理组采取术前宣教、术中全身麻醉、术后应用自控镇痛泵的措施进行疼痛管理,疼痛管理优化组在传统疼痛管理组的基础上采取术中ICNB和切口周围浸润麻醉等措施。比较两组患者围手术期血流动力学指标、应激指标、术后疼痛情况、术后镇静情况、术后引流管留置时间和术后住院时间。结果 术后4 h,疼痛管理优化组患者心率(HR)明显低于传统疼痛管理组,差异有统计学意义(P<0.01)。术后4 h,传统疼痛管理组患者肾上腺素和去甲肾上腺素水平均高于术前及疼痛管理优化组,差异均有统计学意义(P<0.05)。疼痛管理优化组患者术后引流管留置时间和术后住院时间均明显短于传统疼痛管理组,差异均有统计学意义(P<0.01)。术后4 h和术后12 h,疼痛管理优化组患者视觉模拟评分法(VAS)评分均明显低于传统疼痛管理组,差异均有统计学意义(P<0.01)。结论 围手术期疼痛管理联合ICNB和切口周围浸润麻醉优化措施在胃癌手术患者中的应用效果较好,可降低患者的应激水平和疼痛反应,具有良好的应用价值。Objective To observe the effect of perioperative pain management combined with intercostal nerve block(ICNB) and peri-incision infiltration anesthesia optimization measures in patients with gastric cancer surgery. Method A total of 100 patients with gastric cancer who underwent surgical treatment were divided into traditional pain management group(n=50) and pain management optimization group(n=50) according to the pain management methods. The traditional pain management group was treated with preoperative education, intraoperative general anesthesia, and postoperative self-control analgesic pump measures for pain management. The pain management optimization group was treated with ICNB and peri-incision infiltration anesthesia on the basis of the traditional pain management group. The perioperative hemodynamic indexes, stress indexes, postoperative pain, postoperative sedation, postoperative drainage tube indwelling time and postoperative hospital stay were compared between the two groups. Result At 4 hours after operation, the heart rate(HR) of patients in the pain management optimization group was significantly lower than that in the traditional pain management group, and the difference was statistically significant(P<0.01). At 4 h after operation, the levels of epinephrine and norepinephrine in the traditional pain management group were higher than those before operation and in the pain management optimization group, and the differences were statistically significant(P<0.05). The postoperative drainage tube indwelling time and postoperative hospital stay in the pain management optimization group were significantly shorter than those in the traditional pain management group, and the differences were statistically significant(P<0.01). At 4 h and 12 h after operation, the visual analogue scale(VAS) score of patients in the pain management optimization group was significantly lower than that in the traditional pain management group, and the differences were statistically significant(P<0.01). Conclusion Perioperativ

关 键 词：疼痛管理 胃癌 血流动力学 应激指标 

分 类 号：R735.2[医药卫生—肿瘤]