超声引导下椎板后路阻滞在经皮肾镜取石术中的应用  

Application of ultrasound-guided retrolaminar block in percutaneous nephrolithotomy

作　　者：张硕雅 柯均一 彭宇川 张熙 肖昀 ZHANG Shuoya;KE Junyi;PENG Yuchuan;ZHANG Xi;XIAO Yun(Anesthesia Surgery Center,Graduate Training Base of JinZhou Medical University(Shiyan People's Hospital),Shiyan,Hubei 442700,China;Anesthesia Surgery Center,People's Hospital Affiliated to Hubei University of Medicine,Shiyan,Hubei 442700,China;Wuhan Children's Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430000,China)

机构地区：[1]锦州医科大学研究生培养基地(十堰人民医院)麻醉手术中心,湖北十堰442700 [2]湖北医药学院附属人民医院麻醉手术中心,湖北十堰442700 [3]华中科技大学同济医学院附属武汉儿童医院,湖北武汉430000

出　　处：《中国医学工程》2025年第3期41-46,共6页China Medical Engineering

摘　　要：目的 评估超声引导下椎板后路阻滞(RLB)在经皮肾镜取石术中的临床应用效果。方法 选择择期行单侧经皮肾镜取石术60例并随机分成两组,各30例,R组在超声引导下于T10水平进行RLB后接受气管插管下全身麻醉,G组单纯在气管插管下行全身麻醉。记录患者围术期麻醉药物的总用量及手术时长,术后2 h、6 h、12 h、18 h、24 h静息和运动时视觉模拟评分(VAS评分)、补救镇痛需求次数及术后不良反应发生的情况。结果 与G组相比,R组患者术中瑞芬太尼用量减少(P<0.05),术后2 h、6 h、12 h、18 h,VAS评分降低(P<0.05),术后补救镇痛需求及术后不良反应发生减少(P<0.05)。结论 超声引导下RLB可以安全地应用于经皮肾镜取石术,能够在减少术中阿片类药物用量,降低术后不良反应发生率的同时提供良好的术后镇痛,具有较好的临床应用价值。【Objective】To evaluate the clinical effect of ultrasound-guided retrolaminar block in percutaneous nephrolithotomy.【Methods】Sixty cases of unilateral percutaneous nephrolithotomy were selected and randomly divided into 2 groups(n=30).Group R received general anesthesia under endotracheal intubation after retrolamina block at the T10 level under ultrasound guidance,and group G received general anesthesia under endotracheal intubation only.The total dosage of perioperative anesthetic drugs and the duration of operation,Visual Analogue Scale(VAS)scores at rest and exercise at 2,6,12,18,and 24 hours after surgery,the number of acute analgesia needs and the occurrence of postoperative adverse reactions were recorded.【Results】Compared with group G,the intraoperative dosage of remifentanil in group R was decreased(P<0.05),VAS score was decreased 2,6,12 and 18 hours after surgery(P<0.05),and the number of postoperative acute analgesia needs and incidence of nausea were decreased(P<0.05).【Conclusion】Ultrasound-guided retrolaminar block can be safely applied in percutaneous nephrolithotomy,with exact analgesic effect,reducing intraoperative opioid consumption,providing good postoperative analgesia,and reducing the incidence of postoperative adverse reactions,which has good clinical application value.

关 键 词：椎板后路阻滞 超声引导 加速康复外科 经皮肾镜取石术 早期康复 术后镇痛 

分 类 号：R614.3[医药卫生—麻醉学]