超声引导下胸椎旁神经阻滞复合全身麻醉在胸腔镜肺癌根治术中的应用效果  

Application of ultrasound guided thoracic paravertebral nerve block combined with general anesthesia in thoracoscopic radical resection of lung cancer

作　　者：王娜 张丽娟 韩文冬[1] 王瑞娟 WANG Na;ZHANG Lijuan;HAN Wendong;WANG Ruijuan(Department of Anesthesiology,Anyang People’s Hospital No.6,Anyang 455000,He’nan,China;Department of Anesthesiology,the First People’s Hospital of Anyang,Anyang 455000,He’nan,China)

机构地区：[1]安阳市第六人民医院麻醉科,河南安阳455000 [2]安阳市第一人民医院麻醉科,河南安阳4550000

出　　处：《癌症进展》2023年第7期774-776,780,共4页Oncology Progress

摘　　要：目的探讨超声引导下胸椎旁神经阻滞复合全身麻醉在胸腔镜肺癌根治术中的应用效果。方法根据麻醉方式的不同将93例胸腔镜肺癌根治术患者分为对照组(n=45)和观察组(n=48),对照组患者给予全身麻醉,观察组患者给予超声引导下胸椎旁神经阻滞复合全身麻醉。比较两组患者的镇痛药物使用情况、术后不同状态下疼痛程度[视觉模拟评分法(VAS)]和不良反应发生情况。结果观察组患者术中瑞芬太尼用量明显低于对照组,差异有统计学意义(P﹤0.01);术后24、48 h,观察组患者静脉自控镇痛泵按压次数明显少于对照组,差异均有统计学意义(P﹤0.01)。静息状态时,两组患者VAS评分均随着时间推移逐渐降低,且观察组患者术后12、24 h的VAS评分均明显低于对照组,差异均有统计学意义(P﹤0.01);活动状态时,两组患者VAS评分均随着时间推移逐渐降低,且观察组患者术后12、24、48 h的VAS评分均明显低于对照组,差异均有统计学意义(P﹤0.01)。观察组患者的不良反应总发生率为8.33%(4/48),与对照组患者的8.89%(4/45)比较,差异无统计学意义(P﹥0.05)。结论胸腔镜肺癌根治术中给予超声引导下胸椎旁神经阻滞复合全身麻醉的效果确切,可有效控制镇痛药物剂量,且术后镇痛效果显著,安全性佳。Objective To investigate the effect of ultrasound guided thoracic paravertebral nerve block combined with general anesthesia in thoracoscopic radical resection of lung cancer.Method A total of 93 patients undergoing thoracoscopic radical resection of lung cancer were divided into control group(n=45)and observation group(n=48)according to different anesthesia methods.The patients in the control group were given general anesthesia,and the patients in the observation group were given ultrasound guided thoracic paravertebral nerve block combined with general anesthesia.The use of analgesic drugs,the degree of pain in different postoperative states[visual analogue scale(VAS)],and the occurrence of adverse events were compared between the two groups.Result The intraoperative dosage of remifentanil in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.01).At 24 and 48 h after the surgery,the number of intravenous pump compressions in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).At rest,the VAS scores of both groups decreased over time,and the VAS scores in the observation group were lower than those in the control group at 12 and 24 h after the surgery,and the differences were statistically significant(P<0.01).During the active state,the VAS scores of both groups gradually decreased with time,and the VAS scores in the observation group at 12,24 and 48 h after the surgery were lower than those in the control group,and the differences were statistically significant(P<0.01).The total incidence of adverse reactions in the observation group was 8.33%(4/48),which was not significantly different from 8.89%(4/45)in the control group(P>0.05).Conclusion The effect of ultrasound guided thoracic paravertebral nerve block combined with general anesthesia during thoracoscopic radical resection of lung cancer is accurate.This method could effectively control the dos

关 键 词：胸腔镜肺癌根治术 胸椎旁神经阻滞 安全性 疼痛评分 全身麻醉 

分 类 号：R734.2[医药卫生—肿瘤]