竖脊肌神经阻滞联合全身麻醉对脊柱侧弯矫形术患者麻醉效果的影响  

Effect of erector spinae nerve block combined with general anesthesia on anesthesia effect in patients undergoing scoliosis correction

作　　者：杨皓元 姜巧巧[1] 李爱梅[1] YANG Haoyuan;JIANG Qiaoqiao;LI Aimei(Department of Anesthesiology,First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)

机构地区：[1]新疆医科大学第一附属医院麻醉科,新疆乌鲁木齐830054

出　　处：《当代医学》2023年第28期115-118,共4页Contemporary Medicine

基　　金：新疆维吾尔自治区自然科学基金资助项目(2019D01C298)。

摘　　要：目的探讨竖脊肌神经阻滞联合全身麻醉对脊柱侧弯矫形术患者术中唤醒质量及术后视觉模拟评分法(VAS)评分的影响。方法选取2020年3月至2022年7月新疆医科大学第一附属医院收治的20例脊柱侧弯患者作为研究对象,随机分为观察组与对照组,每组10例。观察组给予竖脊肌神经阻滞联合全身麻醉,对照组给予全身麻醉,比较两组围手术期唤醒指标[平均动脉压(MAP)、心率(HR)、躁动发生率、呛咳发生率]及不同时间疼痛评分。结果两组躁动、呛咳发生率比较差异无统计学意义;观察组唤醒时间、MAP、HR均低于对照组,差异有统计学意义(P<0.05)。术后12、24 h,两组术后各时间点VAS评分均低于前一时间点,差异有统计学意义(P<0.05);术后6、12、24 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。结论竖脊肌神经阻滞联合全身麻醉可缩短术中唤醒时间,降低唤醒期间呛咳、躁动发生率,改善术后患者疼痛,维持患者术中血流动力学稳定,减轻术后疼痛程度。Objective To investigate the effect of erector spinae nerve block combined with general anesthesia on intraoperative wake-up quality and postoperative visual analogue scale(VAS)score in patients undergoing scoliosis correction.Methods 20 patients with scoliosis admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2020 to July 2022 were randomly divided into the observation group and the control group,with 10 cases in each group.The observation group was given erector spinae nerve block combined with general anesthesia,and the control group was given thedgeneral anesthesia,the perioperative wake-up indexes(mean arterial pressure[MAP],heart rate[HR],incidence of agita-tion,incidence of cough)and pain scores at different time points were compared between the two groups.Results There were no significant differ-ences in the incidence of agitation and cough between the two groups;the wake-up time,MAP and HR in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 12,24 h after operation,the VAS scores of the two groups at each time point after operation were lower than those at the previous time point,and the differences were statistically significant(P<0.05).At 6,12 and 24 h after operation,the VAS scores in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The erector spinae nerve block combined with general anesthesia can shorten the intraoperative wake-up time,re-duce the incidence of cough and agitation during wake-up,improve postoperative pain,maintain intraoperative hemodynamic stability,and reduce postoperative pain.

关 键 词：竖脊肌神经阻滞 脊柱侧弯 唤醒质量 

分 类 号：R614[医药卫生—麻醉学] R68[医药卫生—外科学]