星状神经节和胸椎旁阻滞对胸腔镜肺癌手术病人术后疼痛的疗效  

Effect of stellate ganglion block combined with thoracic paravertebral block on postoperative pain in patients undergoing thoracoscopic lung cancer surgery

作　　者：郑卫雷 王晓恬 吴婷婷 葛超 刁玉晶 ZHENG Weilei;WANG Xiaotian;WU Tingting;GE Chao;DIAO Yujing(Department of Anesthesio-logy and Perioperative Medicine,Qingdao Central Hospital,University of Health and Rehabilitation Sciences(Qingdao Central Medical Group),Qingdao 266042,China)

机构地区：[1]康复大学青岛中心医院(青岛市中心医疗集团)麻醉与围术期医学科,山东青岛266042 [2]康复大学青岛中心医院(青岛市中心医疗集团)疼痛科,山东青岛266042

出　　处：《青岛大学学报（医学版）》2024年第5期705-708,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医学会舒适化医疗科研基金(YXH2020-ZX031)。

摘　　要：目的观察星状神经节阻滞(SGB)联合胸椎旁阻滞(TPVB)对胸腔镜肺癌手术病人术后疼痛的临床疗效。方法选取我院2023年1-6月在胸腔镜下行肺癌手术治疗的病人80例,随机将病人分到SGB联合TPVB组(T组)和TPVB组(C组)。记录病人术后不同时间点的数字疼痛评分法(NRS)评分和Ramsay评分,术中舒芬太尼和瑞芬太尼用量,术后镇痛泵的有效按压次数和补救镇痛次数。结果T组病人的术后2、6 h静息和运动NRS评分低于C组(Z=1.962~5.807,P<0.05),术后0.5 h运动NRS评分低于C组(Z=3.844,P<0.05)。T组病人的术中舒芬太尼用量、术后48 h内有效按压次数少于C组(Z=3.671、4.284,P<0.05)。结论SGB联合TPVB可以减少胸腔镜肺癌手术病人术中和术后阿片类用药,减轻术后疼痛。Objective To investigate the clinical efficacy of stellate ganglion block(SGB)combined with thoracic paravertebral block(TPVB)in the treatment of postoperative pain in patients undergoing thoracoscopic lung cancer surgery.Methods A total of 80 patients who underwent thoracoscopic lung cancer surgery in our hospital from January to June 2023 were enrolled and randomly divided into SGB+TPVB group(group T)and TPVB group(group C).Numerical Rating Scale(NRS)score and Ramsay score were recorded at different time points after surgery,as well as the amount of sufentanil and remifentanil used during surgery,the number of effective presses of analgesia pump after surgery,and the number of salvage analgesia attempts.Results Compared with group C,group T had significantly lower NRS scores in resting and exercise states at 2 and 6 h after surgery(Z=1.962-5.807,P<0.05)and a significantly lower NRS score in exercise state at 0.5 h after surgery(Z=3.844,P<0.05).Compared with group C,group T had significantly lower amount of sufentanil and remifentanil used during surgery and number of effective presses within 48 h after surgery(Z=3.671,4.284,P<0.05).Conclusion SGB combined with TPVB can reduce the amount of opioids used during and after surgery and alleviate postoperative pain in patients undergoing thoracoscopic lung cancer surgery.

关 键 词：神经传导阻滞 星状神经节 疼痛 手术后 肺肿瘤 胸腔镜检查 治疗结果 

分 类 号：R614.4[医药卫生—麻醉学]