摘要
目的探讨超声引导下不同神经阻滞方法对乳腺癌根治术患者术后镇痛的影响。方法选择86例行乳腺癌根治术的患者,根据随机数字表法分为A组(45例)及B组(41例),A组采用超声引导下胸椎旁神经阻滞麻醉,B组采用胸神经阻滞麻醉,对比两组患者的镇痛持续时间、术后24 h舒芬太尼的使用量、两组T2~T6痛觉减退的比例、术后2 h、4 h、6 h、12 h、24 h、48 h的VAS评分及镇痛期间的并发症。结果A组的镇痛持续时间短于B组,A组术后24 h舒芬太尼用量高于B组(P<0.05)。两组在T3~T6节段的痛觉减退比例对比无统计学意义,而B组在T2节段的痛觉减退比例明显高于A组(P<0.05)。术后2 h、4 h、6 h、12 h时,B组的VAS评分明显低于A组(P<0.05),术后24 h及48 h时,两组患者的VAS评分对比无统计学意义(P>0.05)。两组均无神经阻滞相关并发症及术后并发症。结论超声引导下胸神经阻滞的麻醉方法对乳腺癌根治术患者术后镇痛效果更好,值得临床推广应用。
Objective To investigate the effect of ultrasound-guided different nerve block methods on postoperative analgesia in patients undergoing radical mastectomy. Methods 86 cases patients with radical mastectomy were selected and divided into group A( 45 cases) and group B( 41 cases). Group A were given ultrasound-guided perthoracic nerve block anesthesia,group B were given chest block anesthesia,the analgesia duration,sufentanil using dose after surgery for 24 h,the ratio of T2-T6 hypoalgesia in the 2 groups,the VAS score after surgery for 2 h,4 h,6 h,12 h,24 h,48 h and complications during analgesia in the 2 groups were compared. Results The duration of analgesia in group A was shorter than that of group B,and the sufentanil using dose of group A was higher than that of group B( P < 0. 05). The proportion of hypoalgesia at T3 ~ T6 in the 2 groups had no significant difference,the proportion of hypoalgesia at T2 in group B was obvious higher than group A( P < 0. 05). The VAS score after surgery for 2 h,4 h,6 h,12 h of group A were obvious lower than group B( P < 0. 05). And there were no nerve block related complications and postoperative complications in the 2 groups. Conclusion The anesthesia method of thoracic nerve block guided by ultrasonography has better analgesic effect on patients with radical mastectomy and which is worthy of clinical application.
作者
孟剑
张红琦
刘曼曼
MENG Jian;ZHANG Hongqi;LIU Manman(First People's Hospital of Jining,Jining,272011)
出处
《实用癌症杂志》
2020年第1期149-152,共4页
The Practical Journal of Cancer
关键词
超声引导
不同神经阻滞
乳腺癌根治术
术后镇痛
VAS评分
Ultrasound guidance
Different nerve blocks
Radical mastectomy
Postoperative analgesia
VAS score
