|
| 超声引导下胸椎旁神经阻滞对胸腔镜手术患者苏醒质量及术后镇痛的影响 |
| Effect of ultrasound-guided thoracic paravertebral nerve block on the quality of recovery and postoperative analgesia in patients undergoing thoracoscopic surgery |
| |
| DOI：10.12089/jca.2019.05.001 |
| 中文关键词: 胸椎旁神经阻滞 胸腔镜 术后镇痛 苏醒质量 |
| 英文关键词: Thoracic paravertebral nerve block Thoracoscopic Postoperative analgesia Recovery quality |
| 基金项目: |
|
| 摘要点击次数: 3297 |
| 全文下载次数: 1307 |
| 中文摘要: |
目的 评估超声引导下胸椎旁神经阻滞 (thoracic paravertebral nerve block, TPVB)复合全麻对胸腔镜下肺叶切除术患者苏醒质量及术后镇痛的影响。
方法 择期行胸腔镜下肺叶切除术患者52例，男34例，女18例，年龄25~65岁，BMI 19~28 kg/m2, ASA Ⅰ或Ⅱ级。按随机数字表法分为胸椎旁神经阻滞联合全麻组（观察组）和单纯全麻组（对照组），每组26例。麻醉诱导前观察组在超声引导下行单次椎旁神经阻滞，注射0.375%罗哌卡因25 ml；对照组不做任何处理。两组麻醉诱导后均采用全凭静脉麻醉，术后给予患者静脉自控镇痛。记录自主呼吸恢复时间、苏醒时间、拔管时间、术后镇静-躁动评分(SAS)，记录术后1、6、12、24、48 h静息及咳嗽时VAS评分，记录镇痛药物使用及恶心呕吐、瘙痒、尿潴留、嗜睡、呼吸抑制和低血压等不良反应的发生情况。
结果 两组自主呼吸恢复时间、苏醒时间、拔管时间差异无统计学意义。两组术后不同时点静息时VAS评分差异无统计学意义。与对照组比较，观察组术后SAS评分、术后1、6、12 h的咳嗽时VAS评分明显降低(P<0.05)，术后48 h内镇痛泵有效按压次数明显减少(P<0.05)。两组不良反应差异无统计学意义。
结论 TPVB联合全麻镇痛效果确切，术后苏醒质量高，可安全有效地用于胸腔镜下肺叶切除术患者。 |
| 英文摘要: |
Ojective To evaluate the effect of ultrasound-guided thoracic paravertebral block (TPPB) combined with general anesthesia on the quality of recovery and postoperative analgesia in patients undergoing thoracoscopic lobectomy.
Methods Fifty-two patients underwent elective thoracoscopic lobectomy were recruited, including 34 males and 18 females, falling into ASA physical status Ⅰor Ⅱ. The patients were divided into thoracic paravertebral nerve block combined with general anesthesia group (observation group) and single general anesthesia group (control group) by random number table method, and there were 26 cases in each group. Before the induction of anesthesia, the patients in the observation group underwent a single paravertebral nerve block under ultrasound guidance and injected 0.375% ropivacaine 25 ml; the control group did not receive any treatment. Total intravenous anesthesia was used after induction of anesthesia in both groups, and intravenous analgesia (PCIA) was given after surgery. The spontaneous breathing recovery time, recovery time, extubation time and postoperative agitation were observed and recorded. The VAS scores during a cough and rest at 1, 6, 12, 24, 48 h after surgery, the analgesic drug use, and the adverse reactions were also recorded. The analgesic drug use and adverse reactions (nausea, vomiting, itching, urinary retention, lethargy, respiratory depression and hypotension) were also recorded.
Results There were no significant differences in spontaneous breathing recovery time, recovery time, and extubation time between the two groups. There was no statistically significant difference in VAS scores during rest between the two groups at different postoperative points. However, compared with the control group, the postoperative sedation-stasis score (SAS), VAS scores during a cough at postoperative 1, 6, 12 h were significantly lower in observation group (P < 0.05), and the number of analgesic pumps was decreased considerably in the observation group within 48 h after the operation compared with the control group (P < 0.05). In addition, there was no difference in adverse events between the two groups.
Conclusion Ultrasound-guided thoracic paravertebral nerve block has a good analgesic effect and high recovery quality after surgery. It can be safely and effectively used in patients undergoing thoracoscopic lobectomy. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
