超声引导下胸椎旁神经阻滞联合全身麻醉在乳腺癌根治术中的镇痛效果及安全性  

Analgesic Effect and Safety of Ultrasound-guided Thoracic Paravertebral Nerve Block Combined with General Anesthesia in Radical Mastectomy

作　　者：张桂珍 黄鸿敏 李月香 ZHANG Guizhen;HUANG Hongmin;LI Yuexiang(Qingliu County General Hospital,Qingliu 365300,China;不详)

机构地区：[1]清流县总医院,福建清流365300

出　　处：《中外医学研究》2024年第14期100-103,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析超声引导下胸椎旁神经阻滞联合全身麻醉在乳腺癌根治术中的镇痛效果及安全性。方法:选取2022年2月—2023年7月清流县总医院收治的120例乳腺癌根治术患者。根据随机数表法将其分为常规麻醉组和联合麻醉组,各60例。常规麻醉组接受全身麻醉,联合麻醉组接受超声引导下胸椎旁神经阻滞联合全身麻醉。比较两组术后2 h、4 h、8 h及12 h疼痛程度,术前、术后3 d认知功能,麻醉药物用药量及不良反应。结果:联合麻醉组患者术后2 h、4 h、8 h、12 h的视觉模拟评分法(VAS)评分低于常规麻醉组,差异有统计学意义(P<0.05)。联合麻醉组术后3 d的简易精神状态检查量表(MMSE)评分高于常规麻醉组,丙泊酚用量明显少于常规麻醉组,差异有统计学意义(P<0.05)。联合麻醉组不良反应发生率低于常规麻醉组,差异有统计学意义(P<0.05)。结论:采取超声引导下胸椎旁神经阻滞联合全身麻醉对接受乳腺癌根治术的患者进行麻醉干预,能够有效改善其术后疼痛程度,降低不良反应的发生率,且对患者认知程度的影响较小,效果理想。Objective:To analyze the analgesic effect and safety of ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia in radical mastectomy.Method:A total of 120 patients with radical mastectomy treated in Qingliu County General Hospital from February 2022 to July 2023 were selected.According to random number table method,they were divided into conventional anesthesia group and combined anesthesia group,60 cases in each group.The conventional anesthesia group received general anesthesia,and the combined anesthesia group received ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia.The pain degree at 2 h,4 h,8 h and 12 h after surgery,cognitive function before and 3 d after surgery,anesthetic drug dosage and adverse reactions were compared between the two groups.Result:The visual analogue scale(VAS)scores in the combined anesthesia group were lower than those in the conventional anesthesia group at 2 h,4 h,8 h and 12 h after surgery,and the differences were statistically significant(P<0.05).The score of mini cognitive mental state assessment scale(MMSE)in the combined anesthesia group was higher than that in the conventional anesthesia group,and the dosage of Propofol was significantly lower than that in the conventional anesthesia group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in combined anesthesia group was lower than that in conventional anesthesia group,and the difference was statistically significant(P<0.05).Conclusion:Ultrasoundguided thoracic paravertebral nerve block combined with general anesthesia for patients undergoing radical mastectomy can effectively improve the degree of postoperative pain,reduce the incidence of adverse reactions,and have little impact on the cognitive degree of patients,with ideal effects.

关 键 词：超声引导 胸椎旁神经阻滞 全身麻醉 乳腺癌根治术 效果 

分 类 号：R614.2[医药卫生—麻醉学] R737.9[医药卫生—外科学]