超声引导下竖脊肌平面阻滞复合喉罩麻醉在肺癌根治术中的应用效果  

Application Effect of Ultrasound-Guided Erector Spinal Plane Block Combined with Laryngeal Mask Airway Anesthesia in Radical Surgery of Lung Cancer

作　　者：李焕丽 冯凤喜 王卫民 李印玉 郝静娴 韩劲松[1] LI Huani;FENG Fengxi;WANG Weimin;LI Yinyu;HAO Jingxian;HAN Jingsong(Anesthesiology Department,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院麻醉科,河南周口466000

出　　处：《河南医学研究》2024年第2期330-333,共4页Henan Medical Research

摘　　要：目的探究肺癌根治手术患者应用超声引导下竖脊肌平面阻滞(ESPB)复合喉罩麻醉的临床效果。方法选取2018年6月至2022年6月周口市中心医院104例接受胸腔镜肺癌根治术治疗的非小细胞肺癌(NSCLC)患者,采用随机数表法分为两组,各52例。对照组接受复合喉罩通气麻醉,观察组接受超声引导下ESPB复合喉罩通气麻醉。比较两组患者麻醉诱导前、插管时血流动力学指标(心率、平均动脉压),麻醉苏醒后15 min、6 h、12 h的疼痛程度采用视觉模拟评分法(VAS)评估,比较两组拔管、苏醒、麻醉复苏室停留时间及麻醉苏醒后15 min时患者躁动发生情况[采用躁动行为量表(ABS)评估]。结果两组插管时心率、平均动脉压与麻醉诱导前比较差异无统计学意义(P>0.05)。麻醉苏醒后15 min、6 h、12 h,两组VAS评分均升高,且观察组各时点评分低于对照组(P<0.05)。观察组拔管时间、苏醒时间及麻醉复苏室停留时间均短于对照组(P<0.05)。麻醉苏醒后15 min时,观察组患者躁动发生率低于对照组(P<0.05)。结论超声引导下ESPB复合喉罩通气麻醉对NSCLC手术患者的血流动力学影响小,镇痛效果强,可缩短拔管、苏醒及麻醉复苏室停留时间,降低苏醒期躁动发生率。Objective To explore the clinical effect of ultrasound-guided erector spinae plane block(ESPB)combined with laryngeal mask anesthesia in patients undergoing radical surgery for lung cancer.Methods A total of 104 patients with non-small cell lung cancer(NSCLC)who underwent thoracoscopic radical resection of lung cancer in Zhoukou Central Hospital from June 2018 to June 2022 were selected and divided into two groups by random number table method,with 52 cases in each group.The control group received combined laryngeal mask airway anesthesia,and the observation group received ESPB combined laryngeal mask airway anesthesia under ultrasound guidance.The hemodynamic indexes(heart rate and mean arterial pressure)before anesthesia induction and during intubation were compared between the two groups.The pain degree at 15 minutes,6 and 12 hours after recovery from anesthesia assessed by visual analogue scale(VAS).The duration of extubation,recovery,anesthesia recovery room and the incidence of agitation at 15 minutes after anesthesia recovery were compared between the two groups[assessed by the agitation behavior scale(ABS)].Results Comparison of heart rate and mean arterial pressure between intubation and before anesthesia induction in two groups,the difference was not statistically significant(P>0.05).At 15 minutes,6 and 12 hours after recovery from anesthesia,the VAS scores of the two groups increased,but compared with the control group,the VAS scores of the observation group at each time point were lower(P<0.05).Compared with the control group,the extubation time,awakening time and the stay time in the anesthesia and resuscitation room in the observation group were shorter(P<0.05).15 minutes after recovery from anesthesia,the incidence of restlessness in the observation group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided ESPB combined with laryngeal mask ventilation anesthesia has little effect on hemodynamics in patients undergoing NSCLC surgery,and has a strong analgesic effect.It can

关 键 词：非小细胞肺癌 麻醉 镇痛 喉罩通气麻醉 竖脊肌平面阻滞 

分 类 号：R614.2[医药卫生—麻醉学]