超声引导胸椎旁阻滞与阿片类药物在胸腔镜手术后患者中重度疼痛中的有效性  

Efficacy of Ultrasus-guided Thoracic Paravertebral Block and Opioids in Patients with Moderate to severe Pain after Thoracoscopic Surgery

作　　者：马恒涛 杨黎 王勇 李志英 MA Hengtao;YANG Li;WANG Yong;LI Zhiying(Department of Anesthesiology,926 th Hospital of Joint Logistic Support Force,Kaiyuan 661600,Yunnan,China)

机构地区：[1]联勤保障部队第九二六医院麻醉科,云南开远661600

出　　处：《系统医学》2024年第24期86-89,共4页Systems Medicine

摘　　要：目的 分析超声引导胸椎旁阻滞对比阿片类药物在胸腔镜手术(video-assisted thoracoscopic surgery vats, VATS)后中重度疼痛的治疗作用。方法 非随机选取2022年7月—2023年7月联勤保障部队第九二六医院收治的80例VATS患者为研究对象,按照治疗方式不同分为观察组和对照组,各40例。分别将超声引导胸椎旁阻滞和阿片类药物镇痛用于两组患者,分析患者术后疼痛情况及不良反应发生情况,并对比两组患者的应激反应。结果 观察组术后各时间点视觉模拟评分低于对照组,差异有统计学意义(P均<0.05)。术后1、2 h时心率、中心静脉压在两组均升高,但观察组低于对照组,差异有统计学意义(P均<0.05)。观察组不良反应发生率为2.50%(1/40),低于对照组的20.00%(8/40),差异有统计学意义(χ^(2)=4.507,P<0.05)。结论 超声引导胸椎旁阻滞相较于阿片类药物镇痛,前者治疗VATS后中重度疼痛的治疗效果更佳,不仅不良反应少,还可减轻术后应激反应,确保了体征的稳定。Objective To analyze the effects of ultrasound guided thoracic paravertebral block compared with opioids in the treatment of moderate and severe pain after video-assisted thoracoscopic surgery(VATS).Methods A total of eighty patients with VATS admitted to the 926 Hospital of the Joint Logistic Support Force from July 2022 to July 2023 were non-randomly selected as the research objects.According to different treatment methods,they were divided into the observation group and the control group,forty cases in each group.Ultrasound-guided thoracic paravertebral block and opioid analgesia were used in the two groups,respectively.The postoperative pain and adverse reactions of the patients were analyzed,and the stress response of the two groups was compared.Results The visual analogue scale scores of the observation group were lower than those of the control group at each time point after operation,and the differences were statistically significant(all P<0.05).Heart rate and central venous pressure at 1 h and 2 h after opera‐tion were higher in the two groups,those in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the observation group was 2.50%(1/40),which was lower than 20.00%(8/40)in the control group,and the difference was statistically significant(χ^(2)=4.507,P<0.05).Conclusion Compared with opioid analgesia,ultrasound-guided thoracic paravertebral block has a better therapeutic effect in the treatment of moderate and severe pain after VATS,which not only has fewer adverse reactions,but also reduces the stress response of patients and ensures the stability of physical signs.

关 键 词：超声引导胸椎旁阻滞 阿片类药物 麻醉苏醒室 胸腔镜手术 中重度疼痛 不良反应 应激反应 

分 类 号：R614[医药卫生—麻醉学]