羟考酮联合罗哌卡因椎旁神经阻滞对胸腔镜肺癌切除术患者术后镇痛效果研究  

Effect of oxycodone combined with ropivacaine paravertebral nerve block on postoperative analgesia in patients with thoracoscopic lung cancer resection

作　　者：张丁 高广阔[2] 王菲 魏碧玉 刘伟[1,2] ZHANG Ding;GAO Guangkuo;WANG Fei;WEI Biyu;LIU Wei(Beijing Tuberculosis and Thoracic Tumor Research Institute,Beijing 101100,China;Department of Anesthesiology of Beijing Chest Hospital,Capital Medical University,Beijing 101100,China)

机构地区：[1]北京市结核病胸部肿瘤研究所,北京101100 [2]首都医科大学附属北京胸科医院麻醉科,北京101100

出　　处：《现代肿瘤医学》2022年第23期4357-4361,共5页Journal of Modern Oncology

基　　金：北京市通州区高层次人才发展支持计划(编号:YHLD20190110)。

摘　　要：目的:评价羟考酮联合罗哌卡因程控间歇胸椎旁神经阻滞用于胸腔镜下肺癌切除术对术后镇痛效果的影响。方法:选择60例2020年12月至2021年06月入院择期行胸腔镜下肺癌切除术治疗的患者作为研究对象。采用随机数字表法分为2组:羟考酮+罗哌卡因组(实验组,n=30)和单独罗哌卡因组(对照组,n=30)。记录患者术后1 h、4 h、24 h和48 h时的疼痛NRS评分和镇痛泵按键次数,术后24 h、48 h的QoR15评分,术后不良反应发生情况。结果:术后4 h、24 h、48 h,实验组NRS评分相比对照组均更低(z=-1.982、-2.040、-1.980,P<0.05);术后4 h、24 h、48 h患者按键次数实验组低于对照组(z=-2.012、-2.469、-2.105,P<0.05);术后24 h、48 h时的实验组QoR15评分均高于对照组(t=2.079、2.540,P<0.05);实验组患者术后不良反应总发生率低于对照组(χ^(2)=4.320,P<0.05)。结论:在患者经历胸腔镜肺癌切除术时,与单用罗哌卡因相比,选用超声引导下羟考酮复合罗哌卡因程控间隙椎旁神经阻滞,可获得更理想的镇痛效果,使患者术后恢复质量受到更小影响,且术后不良反应更少,有助于患者手术后早期康复。Objective:To evaluate the effect of oxycodone combined with programmed intermittent thoracic paravertebral nerve block on postoperative analgesia in thoracoscopic surgery.Methods:Sixty patients who were admitted to hospital from December 2020 to June 2021 for elective thoracoscopic resection of lung cancer were selected as the research objects.The patients were randomly divided into two groups:oxycodone+ropivacaine group(experimental group,n=30)and ropivacaine alone group(control group,n=30).The pain NRS score and the number of keys of analgesic pump at 1 h,4 h,24 h and 48 h after operation,qor15 score at 24 h and 48 h after operation and the occurrence of postoperative adverse reactions were recorded.Results:At 4 h,24 h and 48 h after operation,the NRS score of the experimental group was lower than that of the control group(z=-1.982,-2.040,-1.980,P<0.05).The number of keystrokes in the experimental group was less than that in the control group at 4 h,24 h and 48 h after operation(z=-2.012,-2.469,-2.105,P<0.05).QoR15 scores in the experimental group were higher than those in the control group at 24 and 48 hours after operation(t=2.079,2.540,P<0.05).The total incidence of postoperative adverse reactions was lower in the experimental group than that in the control group(χ^(2)=4.320,P<0.05).Conclusion:After undergoing thoracoscopic radical resection of lung cancer,compared with ropivacaine alone,using ultrasound-guided oxycodone combined with ropivacaine programmed interspace paravertebral nerve block can obtain more ideal analgesic effect,less impact on the postoperative recovery quality of patients,and less postoperative adverse reactions,which is conducive to rapid postoperative recovery.

关 键 词：肺癌切除术 麻醉 神经阻滞 术后镇痛 羟考酮 

分 类 号：R734.2[医药卫生—肿瘤]