艾司氯胺酮联合胸椎旁神经阻滞对胸腔镜肺癌根治术后恢复质量的影响  

Effect of Esketamine Combined with Thoracic Paravertebral Nerve Block on the Quality of Recovery after Thoracoscopic Radical Lung Cancer Surgery

作　　者：刘蓓丽 陈永红[1] 徐夏迟 叶帅[1] 宋炳炎 张斌[1] LIU Beili;CHEN Yonghong;XU Xiachi;YE Shuai;SONG Bingyan;ZHANG Bin(Department of Anesthesiology,Nantong Hospital Affiliated to Shanghai University(Nantong Sixth People's Hospital),Nantong 226000,Jiangsu,China)

机构地区：[1]上海大学附属南通医院(南通市第六人民医院)麻醉科,江苏南通226000

出　　处：《系统医学》2025年第5期28-30,39,共4页Systems Medicine

基　　金：南通市卫生健康委员会科研课题专项(MSZ2023063)。

摘　　要：目的探讨艾司氯胺酮镇痛联合胸椎旁神经阻滞对胸腔镜肺癌根治术恢复质量的影响。方法非随机选取2023年3月—2024年3月南通市第六人民医院收治的90例肺癌患者为研究对象,均接受肺癌根治术治疗,根据麻醉方式不同分为研究组(应用艾司氯胺酮联合胸椎旁神经阻滞)和参照组(仅应用胸椎旁神经阻滞),每组45例,对比两组的手术相关指标、血流动力学、应激水平、镇痛泵按压次数、不良反应发生情况。结果两组患者的手术时间、拔管时间比较,差异无统计学意义(P均>0.05);研究组麻醉后护理室停留时间短于参照组,差异有统计学意义(P<0.05)。研究组的血流动力学和应激水平优于参照组,差异有统计学意义(P均<0.05)。研究组术后镇痛泵按压次数为(2.0±6.0)次,低于参照组的(4.0±9.5)次,差异有统计学意义(t=2.697,P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论艾司氯胺酮镇痛联合胸椎旁神经阻滞在胸腔镜肺癌根治术中的应用可有效降低术后疼痛程度,减少镇痛泵使用次数,同时优化患者的应激反应和血流动力学状态,且不增加不良反应风险,具有较好的临床安全性和可行性。Objective To investigate the effect of esketamine analgesia combined with thoracic paravertebral nerve block on the recovery quality of thoracoscopic radical resection of lung cancer.Methods Ninety patients with lung cancer admitted to Nantong Sixth People's Hospital from March 2023 to March 2024 were non-randomly selected as the study subjects,all of whom received radical resection for lung cancer.According to different anesthesia methods,they were divided into the study group(esketamine combined with thoracic paravertebral nerve block)and the reference group(thoracic paravertebral nerve block only),with forty-five cases in each group,and the operation related indexes,hemodynamics,stress level,analgesic pump pressing times and adverse reactions of the two groups were compared.Results There were no significant differences in operation time and extubation time between the two groups(both P>0.05).The stay time of postanesthesia care unit in the study group was shorter than that in the reference group,and the difference was statistically significant(P<0.05).The hemodynamics and stress level of the study group were better than those of the reference group,and the differences were statistically significant(all P<0.05).The number of postoperative analgesic pump compressions in the study group was(2.0±6.0)times,which was lower than(4.0±9.5)times in the reference group,and the difference was statistically significant(t=2.697,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of esketamine analgesia combined with thoracic paravertebral nerve block in thoracoscopic radical resection of lung cancer can effectively reduce the degree of postoperative pain,reduce the number of analgesic pump use,optimize the stress response and hemodynamic status of patients,and do not increase the risk of adverse reactions.It has good clinical safety and feasibility.

关 键 词：胸腔镜肺癌根治术 艾司氯胺酮 胸椎旁神经阻滞 影响 

分 类 号：R614[医药卫生—麻醉学] R734.2[医药卫生—外科学]