右美托咪定联合胸椎旁神经阻滞麻醉对胸腔镜手术患者的临床疗效  

Clinical Efficacy of Dexmedetomidine Combined with Thoracic Paravertebral Nerve Block Anesthesia in Patients Undergoing Thoracoscopic Surgery

作　　者：林锡群 张铨 LIN Xiqun;ZHANG Quan(Department of Anesthesiology,Putian 95 Hospital,Putian,Fujian 351100,China)

机构地区：[1]莆田九十五医院麻醉科,福建莆田351100

出　　处：《中国医药指南》2025年第7期59-62,共4页Guide of China Medicine

摘　　要：目的 探讨右美托咪定(DEX)联合胸椎旁神经阻滞(TPVB)麻醉对胸腔镜手术患者临床疗效。方法 选取2022年5月至2024年5月莆田九十五医院麻醉科行胸腔镜患者101例为研究对象,根据麻醉方法的不同分为联合麻醉组(50例)和常规麻醉组(51例),两组患者均给予TPVB麻醉治疗,常规麻醉组麻醉诱导给予罗哌卡因,联合麻醉组麻醉诱导给予DEX,比较两组围手术期指标、麻醉效果、炎症因子水平、睡眠质量、认知功能。结果 联合麻醉组的手术时长、麻醉起始时间、意识恢复时间、住院周期均短于常规麻醉组,联合麻醉组的术中出血量、补救镇痛比例均低于常规麻醉组(均P <0.05);联合麻醉组视觉模拟评分法评分、Ramsay评分术后48 h较术后24 h均降低,且联合麻醉组更低(均P <0.05);联合麻醉组肿瘤坏死因子α、白细胞介素8、白细胞介素10均低于常规麻醉组(均P <0.05);出院前联合麻醉组、常规麻醉组睡眠质量、认知功能均高于术前且联合麻醉组更高(均P <0.05)。结论 DEX联合TPVB对胸腔镜手术患者的镇痛镇静效果明显,改善术后睡眠质量,提高认知功能。Objective To Explore the clinical efficacy of dexmedetomidine(DEX)combined with thoracic paravertebral nerve block(TPVB)anesthesia in patients undergoing thoracoscopic surgery.Methods A total of 101 patients who underwent thoracoscopy in the Anesthesiology Department of Putian 95th Hospital from May 2022 to May 2024 were selected as the research subjects.According to different anesthesia methods,they were divided into a combined tissue anesthesia group(50 cases)and a conventional anesthesia group(51 cases).Both groups of patients were treated with TPVB anesthesia,while the conventional anesthesia group was induced with ropivacaine and the combined tissue anesthesia group was induced with DEX.The perioperative indicators,anesthesia effect,inflammatory factor levels,sleep quality,and cognitive function of the two groups were compared.Results The surgical duration,anesthesia initiation time,consciousness recovery time,and hospitalization period of the combined anesthesia group were shorter than those of the conventional anesthesia group.The intraoperative bleeding volume and rescue analgesia ratio of the combined anesthesia group were lower than those of the conventional anesthesia group(all P<0.05).Visual analogue score and Ramsay score in the combined tissue anesthesia group were lower 48 hours after surgery than 24 hours after surgery,and lower in the combined tissue anesthesia group(both P<0.05).Tumor necrosis factor-α,interleukin 8 and interleukin 10 in combined tissue anesthesia group were lower than those in conventional anesthesia group(all P<0.05).The sleep quality and cognitive function of the combined anesthesia group and the conventional anesthesia group before discharge were higher than those before surgery,and the combined anesthesia group was even higher(both P<0.05).Conclusions The combination of DEX and TPVB has a significant analgesic and sedative effect on patients undergoing thoracoscopic surgery,improves postoperative sleep quality,enhances cognitive function.

关 键 词：右美托咪定 胸椎旁神经阻滞 胸腔镜 术后睡眠质量 认知功能 

分 类 号：R614[医药卫生—麻醉学]