超声引导下甲哌卡因经椎旁阻滞联合全身麻醉在肝脏肿瘤切除术后镇痛有效性的临床研究  

Clinical study on the effectiveness of ultrasound-guided paravertebral mepivacaine block combined with general anesthesia for analgesia after liver tumor resection

作　　者：查道喜 刘艳涛 孙玉明 Zha Daoxi;Liu Yantao;Sun Yuming(Third Naval Medical University Hospital,Shanghai 200433,China)

机构地区：[1]海军军医大学第三附属医院,上海200433

出　　处：《首都食品与医药》2024年第17期25-30,共6页Capital Food Medicine

摘　　要：目的 探讨超声引导下甲哌卡因经椎旁阻滞联合全身麻醉在肝脏肿瘤切除术后镇痛有效性的临床研究.方法 选取2022年2月-2023年12月在海军军医大学第三附属医院肝胆外科就诊治疗的80例肝细胞癌患者为研究对象,其中男性患者56例,女性患者24例.所有患者行肝肿瘤切除术,根据术中麻醉方式将患者分为对照组(n=40)和观察组(n=40),对照组给予静脉喉罩全身麻醉,观察组给予超声引导下甲哌卡因经椎旁阻滞联合全身麻醉.所有患者自愿参与研究并签署知情同意书.统计两组患者一般资料.比较两组患者围手术期生命体征指标.使用VAS量表比较两组患者术后1h、术后12h和术后24h的疼痛情况.比较两组患者麻醉苏醒时间及术后镇痛情况、术后不良反应发生情况、术后恢复质量.结果 两组患者一般资料比较,无明显差异(P>0.05).T0、T1、T2时两组患者MAP、HR及SpO2比较,无明显差异(P>0.05),T3时,观察组患者MAP和HR较对照组降低(P<0.05),SpO2比较,无明显差异(P>0.05).观察组术后1h、术后12h和术后24h VAS评分较对照组降低(P<0.05).观察组PCIA按压次数和氟比洛芬酯用量较对照组减少(P<0.05),观察组麻醉苏醒时间较对照组缩短(P<0.05).观察组不良反应发生率较对照组降低(P<0.05).观察组术后恢复质量评分较对照组升高(P<0.05).结论 超声引导下甲哌卡因经椎旁阻滞联合全身麻醉在肝脏肿瘤切除术后镇痛方面具有显著效果.相较于传统麻醉方法,该方法能有效降低术后疼痛评分,减少镇痛药物的使用,缩短麻醉苏醒时间,并降低术后不良反应发生率,提高术后恢复质量.Objective To explore the clinical study on the effectiveness of ultrasound-guided mepivacaine transvertebral block combined with general anesthesia for analgesia after liver tumor resection.Methods 80 patients with hepatocellular carcinoma who received.treatment in the Hepatobiliary Surgery Department of our hospital from February 2022 to December 2023 were selected as the research subjects,including 56 male patients and 24 female patients.All patients underwent liver tumor resection surgery and were divided into a control group(n=40)and an observation group(n=40)according to the intraoperative anesthesia method.The control group was given intravenous laryngeal mask general anesthesia,while the observation group was given ultrasound-guided methylprednisolone combined with paravertebral block and general anesthesia.All patients voluntarily participate in the study and sign informed consent.Collect general information of two groups of patients.Compare the perioperative vital signs of patients.Compare the pain levels of patients at 1 hour,12 hours,and 24 hours after surgery using VAS scales.Compare the patient's anesthesia recovery time and postoperative pain relief.Compare the incidence of postoperative adverse reactions in patients.Compare the postoperative recovery quality of patients.Results There was no difference in the general information of the two groups of patients(P>0.05).There was no difference in MAP,HR and SpO2 between the two groups of patients at TO,TI and T2(P>0.05).At T3,the MAP and HR of the patients in the observation group were lower than those of the control group(P<0.05),and there was no difference in Sp02(P>0.05).The VAS scores of the observation group at 1 hour,12 hours and 24 hours after surgery were lower than those in the control group(P<0.05).The number of PCIA compressions and the dosage of flurbiprofen axetil in the observation group were reduced compared with the control group(P<0.05),and the anesthesia recovery time in the observation group was shorter than that in the control group(

关 键 词：超声引导 椎旁阻滞 甲哌卡因 全身麻醉 肝脏肿瘤切除 术后镇痛 

分 类 号：R614.2[医药卫生—麻醉学]