|
| 超声引导下胸椎旁神经阻滞和菱形肌-肋间肌阻滞对胸腔镜术后恢复质量的影响 |
| Effects of ultrasound-guided thoracic paravertebral block versus rhomboid intercostal block on recovery quality after video-assisted thoracoscopic surgery |
| |
| DOI：10.12089/jca.2021.10.011 |
| 中文关键词: 菱形肌-肋间肌阻滞 胸椎旁神经阻滞 胸腔镜手术 术后早期疼痛 恢复质量 |
| 英文关键词: Rhomboid intercostal block Thoracic paravertebral block Video-assisted thoracoscopic surgery Early postoperative pain Quality of recovery |
| 基金项目:广东省汕头市科技计划项目(汕府科〔2017〕119号-21) |
| 作者 | 单位 | E-mail | | 马楚洲 | 515031,广东省汕头市,汕头市中心医院麻醉科 | 584499304@qq.com | | 陈琼仪 | 515031,广东省汕头市,汕头市中心医院麻醉科 | | | 林梓霞 | 515031,广东省汕头市,汕头市中心医院麻醉科 | | | 郑良杰 | 515031,广东省汕头市,汕头市中心医院麻醉科 | | | 吴萍 | 515031,广东省汕头市,汕头市中心医院麻醉科 | |
|
| 摘要点击次数: 2298 |
| 全文下载次数: 671 |
| 中文摘要: |
目的 观察超声引导下胸椎旁神经阻滞(TPVB)和菱形肌-肋间肌阻滞(RIB)对胸腔镜手术患者术后早期疼痛及术后康复质量的影响。
方法 选择全麻下行胸腔镜肺癌根治术患者78例,男51例，女27例，年龄50～70岁,ASAⅠ或Ⅱ级。随机分为两组:超声引导下TPVB组(A组)和超声引导下RIB组(B组),每组39例。全麻诱导前，A组、B组分别采用0.33%罗哌卡因25 ml行超声引导下TPVB和RIB。记录阻滞操作时间和阻滞持续时间。记录术后2、6、24静息和活动时VAS疼痛评分。记录术后24 h内舒芬太尼用量和补救镇痛例数。记录开始进食时间、开始下地时间和术后住院时间。记录PACU低氧血症、气胸、穿刺部位出血或血肿、局麻药中毒、术后谵妄、术后肺不张、恶心呕吐等并发症的发生情况。
结果 B组阻滞操作时间明显短于A组(P<0.05)。两组阻滞持续时间、不同时点静息和活动时VAS疼痛评分、术后24 h内舒芬太尼用量、补救镇痛率、开始进食时间、开始下地时间、术后住院时间差异无统计学意义。两组并发症发生率差异无统计学意义。
结论 在胸腔镜肺癌根治术中，行超声引导下菱形肌-肋间肌阻滞的患者术后恢复质量不差于行胸椎旁神经阻滞的患者。 |
| 英文摘要: |
Objective To observe the effects of ultrasound-guided thoracic paravertebral block (TPVB) and rhomboid intercostal block (RIB) on early postoperative pain and rehabilitation quality in patients undergoing video-assisted thoracoscopic surgery.
Methods Seventy-eight patients underwent thoracoscopic radical resection of lung cancer under general anesthesia, 51 males and 27 females, aged 50-70 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into two groups: ultrasound-guided TPVB group (group A) and ultrasound-guided RIB group (group B), 39 patients in each group. Before induction of general anesthesia, patients in group A and group B received ultrasound-guided TPVB and RIB with 0.33% ropivacaine 25 ml, respectively. The operation time and duration of block, the VAS pain scores at rest and activity 2, 6, and 24 hours after operation, the sufentanil dosage within 24 hours after operation and the number of cases of rescue analgesia were recorded. The time of starting eating, the time of going to the ground and the time of hospitalization after operation were recorded. The complications such as PACU hypoxemia, pneumothorax, puncture site hemorrhage or hematoma, local anesthetic poisoning, postoperative delirium, nausea and vomiting, and postoperative atelectasis were recorded.
Results The time of block operation in group B was significantly shorter than that in group A (P < 0.05). There were no significant differences in the duration of the blocks, VAS pain scores at rest and activity, sufentanil dosage within 24 hours after operation, remedial analgesia rate, feeding onset time, ground movement onset time and postoperative hospitalization time, as well as complication incidence between the two groups.
Conclusion In thoracoscopic radical resection of lung cancer, the postoperative recovery quality of patients undergoing ultrasound-guided RIB were no worse than those undergoing TPVB. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
