摘要
目的观察胸椎旁神经阻滞复合双腔气管插管全身麻醉对肺癌患者术后疼痛及血流动力学的影响。方法依据随机数字表法将85例肺癌患者分为观察组(n=43)和对照组(n=42),对照组患者采用单纯双腔气管插管全身麻醉,观察组患者采用胸椎旁神经阻滞复合双腔气管插管全身麻醉。比较两组患者术后1、3、6、12、24、48 h的视觉模拟评分法(VAS)评分及伯格曼舒适度评分(BCS)。比较两组患者术后24 h内患者自控静脉镇痛(PCIA)泵按压次数、舒芬太尼用量及吗啡用量。比较两组患者入室时(T0)、气管插管时(T1)、气管插管后5 min(T2)、拔管前(T3)、拔管即刻(T4)、拔管后5 min(T5)、拔管后10 min(T6)的平均动脉压、血氧饱和度及心率,比较两组患者T0、T4、T5及T6时刻的呼吸频率。结果观察组患者术后1、3、6、12、24、48 h的VAS评分均低于对照组,术后48 h的BCS评分高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者术后24 h内PCIA泵按压次数、舒芬太尼用量及吗啡用量均明显低于对照组,差异均有统计学意义(P﹤0.01)。与入室时比较,观察组患者在气管插管及拔管过程中的血压、心率及呼吸频率均发生波动,但拔管后10 min和入室时的上述指标比较,差异均无统计学意义(P﹥0.05)。与入室时比较,对照组患者在气管插管及拔管过程中均出现血压、心率及呼吸频率的波动,上述改变持续到拔管后10 min。两组患者气管插管及拔管过程中的血氧饱和度与入室时比较,差异均无统计学意义(P﹥0.05)。结论胸椎旁神经阻滞复合双腔气管插管全身麻醉能够有效减轻肺癌患者的术后疼痛及血流动力学改变。
Objective To investigate the impact of thoracic paravertebral nerve block combined with double-lumen endotracheal intubation on postoperative pain and hemodynamics of general anaesthetized patients with lung cancer.Method 85 patients with lung cancer were randomly divided into observation group(n=43)and control group(n=42).The control group was given general anesthesia with double-lumen endotracheal intubation,while the observation group was given thoracic paravertebral nerve block combined with double-lumen endotracheal intubation.Visual analogue scale(VAS)score and Bruggrmann comfort score(BCS)were compared between the two groups at 1,3,6,12,24,48 h after operation.The pressing times of patient controlled intravenous analgesia(PCIA)pump,sufentanil dosage and morphine dosage were compared between the two groups within 24 h after operation.The mean arterial pressure,arterial oxygen saturation and heart rate at the time of entering the room(T0),at the time of tracheal intubation(T1),5 minutes after tracheal intubation(T2),before extubation(T3),immediately after extubation(T4),5 minutes after extubation(T5),and 10 minutes after extubation(T6),the respiratory rates at T0,T4,T5 and T6 were evaluated between the two groups.Result The VAS scores of observation group at 1,3,6,12,24,48 h after operation were lower than that of control group,and BCS score at 48 h after operation was higher than that of control group(P<0.05).The PCIA pump pressing times at 24 h after operation,sufentanil dosage and morphine dosage in the observation group were significantly lower than those in the control group(P<0.01).The blood pressure,heart rate and respiratory rate of patients in the observation group fluctuated during tracheal intubation and extubation compared with that at the time of entering the room,but there was no significant difference between the above indexes at 10 minutes after extubation and at the time of entering the room(P>0.05).The blood pressure,heart rate and respiratory rate of patients in the control group fluctuate
作者
邱军明
宋爽
安长芝
万迪
QIU Junming;SONG Shuang;AN Changzhi;WAN Di(Department of Anesthesiology,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,Shandong,China)
出处
《癌症进展》
2020年第16期1688-1691,1695,共5页
Oncology Progress
关键词
胸椎旁神经阻滞
双腔气管插管
肺癌
疼痛
血流动力学
thoracic paravertebral nerve block
double-lumen endotracheal intubation
lung cancer
pain
hemodynamic
