连续胸椎旁神经阻滞联合氟比洛芬酯静脉镇痛泵用于胸腔镜肺叶及肺段切除术后镇痛的效果分析  

Effectiveness analysis of continuous thoracic paravertebral nerve block combined with flurbiprofen axetil intravenous analgesia pump for analgesia after thoracoscopic lobectomy and segmentectomy

作　　者：赵艳丽[1] 郭丽[1] 张熙哲[2] Zhao Yanli;Guo Li;Zhang Xizhe(Department of Anesthesiology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Department of Anesthesiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院麻醉科,太原030013 [2]北京大学人民医院麻醉科,北京100044

出　　处：《肿瘤研究与临床》2023年第12期915-918,共4页Cancer Research and Clinic

摘　　要：目的探讨超声引导下连续胸椎旁神经阻滞联合氟比洛芬酯静脉镇痛泵用于胸腔镜肺叶及肺段切除术后镇痛的效果。方法回顾性分析山西省肿瘤医院2021年1月至2021年6月接受胸腔镜肺叶及肺段切除术的68例患者的临床资料,患者根据采用的术后镇痛方法不同分为对照组(36例)和试验组(32例)。对照组接受超声引导下单次胸椎旁神经阻滞联合舒芬太尼及氟比洛芬酯静脉镇痛泵,试验组接受超声引导下连续胸椎旁神经阻滞联合氟比洛芬酯静脉镇痛泵。比较两组患者术后2 d镇痛泵按压次数、静息及活动时视觉模拟评分(VAS)、活动状态和不良反应。结果对照组和试验组患者活动状态评分、静息状态VAS、活动状态VAS、镇痛泵按压次数比较,差异均无统计学意义(均P>0.05)。对照组患者术后第2天活动状态较术后第1天好转(P<0.05),而试验组患者术后第1、2天的活动状态评分、镇痛泵按压次数差异均无统计学意义(均P>0.05)。对照组与试验组患者术后第2天静息状态和活动状态VAS均低于术后第1天(均P<0.05)。对照组发生恶心、头痛5例,头晕2例,试验组发生头晕1例,两组不良反应发生率差异有统计学意义(χ^(2)=4.00,P=0.045)。结论连续胸椎旁神经阻滞在胸腔镜肺叶切除术后镇痛中具有与静脉舒芬太尼相似的良好镇痛效果,但不良反应更少。Objective To investigate the postoperative analgesic effect of ultrasound-guided continuous thoracic paravertebral nerve block combined with flurbiprofen axetil intravenous analgesia pump for thoracoscopic lobectomy and segmentectomy.Methods The clinical data of 68 cases who underwent thoracoscopic lobectomy and segmentectomy in Shanxi Province Cancer Hospital between January 2021 and June 2021 were retrospectively analyzed.According to the postoperative analgesia methods,all patients were divided into the control group(36 cases)and the experimental group(32 cases).The patients in the control group received ultrasound-guided single thoracic paravertebral nerve block combined with sufentanil and flurbiprofen axetil intravenous analgesia pump,and the patients in the experimental group received ultrasound-guided continuous thoracic paravertebral nerve block combined with flurbiprofen axetil intravenous analgesia pump.The pressing times of intravenous analgesia pump,visual simulation score(VAS)during rest and activity,vitality status and adverse reactions of the two groups were compared at 2 d after operation.Results There were no statistically significant differences in VAS during rest and activity and analgesia pump pressing times between the control group and the experimental group(all P>0.05).The vitality status at postoperative day 2 was better than that at postoperative day 1(P<0.05);while,the differences in the vitality status at postoperative day 1 and day 2 as well as the pressing times of analgesia pump in the experimental group were not statistically significant(both P>0.05).The VAS during rest and activity on postoperative day 2 was lower than that on postoperative day 1 among patients in the control group and experimental group(both P<0.05).In the control group,5 cases had nausea and headache,and 2 cases had dizziness;in the experimental group,1 case had dizziness;the difference in the adverse reaction incidence of both groups was statistically significant(χ^(2)=4.00,P=0.045).Conclusions Continuous thor

关 键 词：肺肿瘤 超声引导 连续胸椎旁神经阻滞 胸腔镜手术 

分 类 号：R614[医药卫生—麻醉学]