胸骨旁肋间平面阻滞对老年非体外循环冠状动脉旁路移植术患者术后疲劳的影响  

Effect of parasternal intercostal plane block on postoperative fatigue in elderly patients undergoing off-pump coronary artery bypass grafting

作　　者：周美艳[1] 张哲 王行何 王荣国[1] 孙嘉 王立伟[1] 刘倩[1,2] ZHOU Meiyan;ZHANG Zhe;WANG Xinghe;WANG Rongguo;SUN Jia;WANG Liwei;LIU Qian(Department of Anesthesiology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China;Xuzhou Clinical College,Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市中心医院麻醉科,江苏徐州221000 [2]徐州医科大学徐州临床学院,江苏徐州221000

出　　处：《重庆医学》2024年第21期3211-3214,3221,共5页Chongqing Medical Journal

基　　金：国家自然科学基金项目(82301414);徐州市彭城英才项目(XWRCHT20220017);徐州医科大学附属医院发展基金项目(XYFM202336)。

摘　　要：目的评价胸骨旁肋间平面阻滞(PIB)对老年非体外循环冠状动脉旁路移植术患者术后疲劳的影响。方法选取2021年5月至2023年1月徐州市中心医院择期行非体外循环冠状动脉旁路移植术的111例老年患者为研究对象,采用随机数字表法分为对照组(C组,n=55)和PIB组(P组,n=56)。麻醉诱导后P组患者接受超声引导下双侧PIB,C组在相同部位注射等容量生理盐水。比较患者术后第1、3、5、7天及术后第8周术后疲劳综合征(POFS)发生率,拔管后即刻及术后12、24、48 h数字评分量表(NRS)评分,术后阿片类药物用量、ICU停留时间、住院时间、不良事件发生情况。结果与C组比较,P组术后第1、3、5、7天及术后第8周POFS发生率均明显降低,拔管后即刻及术后12、24 h NRS评分更低,术后阿片类药物用量更少,ICU停留时间更短,差异有统计学意义(P<0.05)。两组术后48 h NRS评分、住院时间比较差异无统计学意义(P>0.05),研究期间均未出现神经阻滞相关不良事件。结论超声引导下PIB能够有效降低老年非体外循环冠状动脉旁路移植术患者POFS发生率,促进患者预后,提升患者恢复质量。Objective To evaluate the effect of parasternal intercostal plane block(PIB)on postoperative fatigue in elderly patients undergoing off-pump coronary artery bypass grafting(CABG).Methods A total of 111 elderly patients undergoing elective off-pump CABG in Xuzhou Municipal Central Hospital from May 2021 to January 2023 were selected as the study subjects.The patients were divided into the control group(group C,n=55)and PIB group(group P,n=56)by adopting the random number table method.After induction of anesthesia,the patients in the group P received the ultrasound-guided bilateral PIB,and the group C received the equal volume of normal saline at the same site.The incidence rate of postoperative fatigue syndrome(POFS)on postoperative 1,3,5,7 d and postoperative 8 weeks,NRS scores immediately after extubation and at postoperative 12,24,48 h,postoperative opioid drugs consumption,ICU stay duration,hospitalization duration and adverse events occurrence were compared between the two groups.Results Compared with the group C,the incidence rates of POFS on postoperative 1,3,5,7 d and postoperative 8 weeks in the group P were significantly decreased,the NRS scores immediately after extubation and at postoperative 12,24 h in the group P were lower,the postoperative opioid drugs consumption were smaller,the ICU stay duration was shorter,and the differences were statistically significant(P<0.05).The NRS score at postoperative 48 h and hospitalization duration had no statistical differences between the two groups(P>0.05).No nerve block related adverse events in the patients appeared during the study period.Conclusion The ultrasound guided PIB could effectively reduce the incidence rate of POFS in elderly patients undergoing off-pump CABG,promote the patients’prognosis and improve the recovery quality of the patients.

关 键 词：胸骨旁肋间平面阻滞 老年 非体外循环 冠状动脉旁路移植术 术后疲劳 

分 类 号：R614.4[医药卫生—麻醉学]