超声引导下胸椎旁神经阻滞和菱形肌-肋间肌阻滞在胸腔镜手术患者中的应用  

Effect of Ultrasound Guided Thoracic Paravertebral Nerve Block and Rhomboid Intercostal Block in Patients Undergoing Thoracoscopic Surgery

作　　者：刘祥 严金燕 孙亚玲 李浩 LIU Xiang;YAN Jinyan;SUN Yaling;LI Hao(Yancheng First People's Hospital,Yancheng 224000,China;不详)

机构地区：[1]盐城市第一人民医院,江苏盐城224000

出　　处：《中外医学研究》2023年第18期41-44,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声引导下胸椎旁神经阻滞(TPVB)与菱形肌-肋间肌阻滞(RIB)对胸腔镜手术患者的影响。方法:选取2021年1月—2022年8月盐城市第一人民医院收治的80例拟于全麻下开展胸腔镜肺癌根治术治疗的患者为研究对象,将其随机分为TPVB组与RIB组,各40例。TPVB组于超声引导下实施TPVB,RIB组于超声引导下实施RIB。比较两组术后疼痛情况、苏醒质量、康复指标及并发症发生情况。结果:术后3 h、6 h、12 h、24 h咳嗽与静息状态下,两组视觉模拟评分法(VAS)疼痛评分比较,差异无统计学意义(P>0.05);两组恢复自主呼吸用时、苏醒用时、拔管用时、阻滞持续时间、Riker镇静-躁动评分标准(SAS)评分比较,差异无统计学意义(P>0.05);RIB组阻滞操作用时短于TPVB组,差异有统计学意义(P<0.05);两组首次进食时间、首次下床活动时间、术后住院天数、首日舒芬太尼用量比较,差异无统计学意义(P>0.05);两组补救镇痛率和并发症发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下TPVB与RIB两种区域神经阻滞镇痛应用于胸腔镜手术患者,在缓解术后早期疼痛、提高苏醒质量、促进术后康复、减少并发症等方面的作用相当,但RIB在缩短阻滞操作时间方面表现更优秀。Objective:To investigate the effect of ultrasound guided thoracic paravertebral nerve block(TPVB)and rhomboid intercostal block(RIB)in patients undergoing thoracoscopic surgery.Method:A total of 80 patients who were admitted to Yancheng First People's Hospital from January 2021 to August 2022 and planned to undergo thoracoscopic radical surgery for lung cancer under general anesthesia were selected as the study subjects.They were randomly divided into TPVB group and RIB group,with 40 patients in each group.The TPVB group underwent TPVB under ultrasound guidance,while the RIB group underwent RIB under ultrasound guidance.The pain after surgery,recovery quality,rehabilitation indicators,and incidence of complications between the two groups were compared.Result:There were no statistically significant differences in visual analogue scale(VAS)pain scores between the two groups at 3 h,6 h,12 h,and 24 h after surgery when coughing and resting(P>0.05).There were no statistically significant differences between the two groups in the time needed to restore autonomous breathing,the time needed to awaken,the time needed to extubate,and the duration of block,sedation-agitation scale(SAS)score(P>0.05).The blocking time of RIB group was shorter than that of TPVB group,and the difference was statistically significant(P<0.05).There were no significant differences between the two groups in the time of first eating,the time of first getting out of bed,the number of days in hospital after surgery,and the dosage of Sufentanil on the first day(P>0.05).There were no statistically significant differences between the two groups in terms of rescue analgesia rate and incidence of complication(P>0.05).Conclusion:The application of ultrasound guided TPVB and RIB regional nerve block analgesia in thoracoscopic surgery patients has similar effects in alleviating early postoperative pain,improving awakening quality,promoting postoperative recovery,and reducing complications.However,RIB performs better in shortening the block time.

关 键 词：超声引导 胸椎旁神经阻滞 菱形肌-肋间肌阻滞 胸腔镜 疼痛 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]