超声引导胸椎旁神经阻滞复合全身麻醉在开胸手术中的应用效果  

Application Effect of Ultrasound-Guided Thoracic Paravertebral Nerve Block Combined with General Anesthesia in Thoracotomy

作　　者：楚桐 李瑞林 CHU Tong;LI Ruilin(Department of Anesthesiology,Hebei North University Affiliated First Hospital,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院麻醉科,河北张家口075000

出　　处：《中国医药指南》2025年第8期109-111,共3页Guide of China Medicine

摘　　要：目的 探讨超声引导胸椎旁神经阻滞复合全身麻醉在开胸手术中的应用效果。方法 选取2023年9月至2024年9月在河北北方学院附属第一医院治疗的86例开胸手术患者,依据随机数表法分为两组,每组43例。对照组单用全身麻醉,观察组使用超声引导胸椎旁神经阻滞复合全身麻醉,对比两组术中血流动力学指标[平均动脉压(MAP)、心率]、术后疼痛程度[视觉模拟评分法(VAS)]和不良反应发生情况。结果 观察组T1、T2、T3的MAP、心率均高于对照组(P <0.05)。相较于对照组,观察组在术后2 h、6 h、12 h、24 h、48 h的VAS评分均更低,且观察组在术后48 h内镇痛泵的按压频次少于对照组(P <0.05)。相较于对照组,观察组术后发生不良反应总发生率更低(P <0.05)。结论 在开胸手术中采用超声引导的胸椎旁神经阻滞结合全身麻醉不仅能有效维持术中的血流动力学稳定性,还能显著减轻术后的疼痛感。Objective To explore the application effects of ultrasound-guided paravertebral nerve block combined with general anesthesia in thoracotomy surgery.Methods A total of 86 patients undergoing thoracotomy at the First Affiliated Hospital of Hebei North University from September 2023 to September 2024 were selected and divided into two groups using a random number table,with 43 patients in each group.The control group received general anesthesia alone,while the observation group received ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia.The intraoperative hemodynamic parameters[mean arterial pressure(MAP),heart rate],postoperative pain levels[Visual Analogue Scale(VAS)],and the incidence of adverse reactions were compared between the two groups.Results The MAP and heart rate of the observation group at T1,T2,and T3 were higher than those of the control group(P<0.05).Compared with the control group,the VAS scores of the observation group at 2 hours,6 hours,12 hours,24 hours,and 48 hours postoperatively were significantly lower,and the frequency of analgesic pump presses within 48 hours postoperatively was also lower in the observation group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusions In thoracotomy,ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia showed significant application results,which can effectively stabilize intraoperative hemodynamics,reduce postoperative pain.

关 键 词：开胸手术 超声引导下椎旁神经阻滞 全身麻醉 凝血指标 

分 类 号：R614[医药卫生—麻醉学]