双侧胸肋间筋膜阻滞对心脏直视手术患者围手术期疼痛管理的影响的临床研究  

Clinical study of the effect of bilateral thoracic intercostal fascia block on the perioperative pain management of patients undergoing open heart surgery

作　　者：田飞 庄彩霞 胡继英[1] Tian Fei;Zhuang cai-xia;Hu Ji-ying(Department of Anesthesiology,Zhengzhou First People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第一人民医院麻醉科,河南郑州450000

出　　处：《四川生理科学杂志》2023年第4期638-641,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨双侧胸肋间筋膜阻滞(Pect-intercostal fascial block,PIFB)对接受心脏直视手术的患者围手术期疼痛管理的影响。方法:选取2021年12月至2022年12月于我院接受心脏直视术的100例患者作为研究对象,按照随机抽签法分为观察组和对照组,各50例。观察组接受双侧PIFB,对照组未接受神经阻滞。比较两组入院后舒芬太尼和帕瑞昔布的消耗量、拔管时间、第一次排便时间、重症监护病房(Intensive care unit,ICU)住院时间、住院时间、术后1、2、3 d的白细胞介素-6(Interleukin,IL-6)、胰岛素、葡萄糖和胰岛素抵抗。结果:观察组术中舒芬太尼消耗量、术后舒芬太尼消耗量、术后帕瑞昔布消耗量、拔管时间、ICU住院时间、住院时间均明显低于对照组(P<0.05);观察组术后1 d、术后2 d、术后3 d的胰岛素、葡萄糖、胰岛素抵抗指数(Homeostasis model assessment-insulin resistance,HOMA-IR)、IL-6的量均明显低于对照组(P<0.05)。结论:双侧PIFB为接受心脏直视手术的患者提供有效的镇痛,并加速患者康复。Objective:To investigate the effect of bilateral pectoral-intercostal fascial block(PIF)on perioperative pain management in patients undergoing open heart surgery.Methods:From December 2021 to December 2022,100 patients receiving open-heart surgery were selected and divided into observation group and control group according to random draw method,with 50 cases in each group.The observation group received bilateral PIFB,while the control group did not receive nerve block.The consumption of sufentanil and parecoxib after admission,extubation time,first bowel movement time,length of stay in intensive care unit(ICU),length of stay,and interleukin-6 at 1,2,and 3 days after surgery were compared between the 2 groups.IL-6),insulin,glucose and insulin resistance.Results:The intraoperative sufentanil consumption,postoperative sufentanil consumption,postoperative parecoxib consumption,extubation time,ICU stay and hospital stay in the observation group were significantly lower than those in the control group,with statistical significance(P<0.05).The levels of insulin,glucose,homeostasis model assessment-insulin resistance(HOMA-IR)and IL-6 in the observation group 1,2 and 3 days after surgery were compared with those in the control group.The differences were statistically significant(P<0.05).Conclusion:Bilateral PIFB provides effective analgesia and accelerated recovery for patients undergoing open-heart surgery.

关 键 词：胸肋间筋膜阻滞 胰岛素抵抗 舒芬太尼 心脏直视手术 

分 类 号：R473.5[医药卫生—护理学]