摘要
目的探讨全身麻醉(以下简称"全麻")复合胸椎旁神经阻滞(TPVB)对胸腔镜肺癌根治术患者的麻醉效果和术后镇痛效果。方法根据麻醉方法的不同将106例接受胸腔镜肺癌根治术的患者分为全麻组和复合组,每组53例,全麻组患者采用单纯全麻,复合组患者采用全麻复合TPVB。比较两组患者的手术时间和血流动力学指标[收缩压(SBP)、舒张压(DBP)、心率(HR)、平均动脉压(MAP)],比较术后2、12、24、48 h两组患者的视觉模拟评分法(VAS)评分,比较术后24、48 h两组患者的静脉自控镇痛(PCIA)泵按压次数、镇痛药物总输注量,比较两组患者的术后恢复指标及麻醉不良反应发生率。结果两组患者的手术时间比较,差异无统计学意义(P﹥0.05);术中两组患者的SBP、DBP、HR均低于本组术前,全麻组患者的MAP高于本组术前,差异均有统计学意义(P﹤0.05);术中复合组患者的SBP、DBP、HR、MAP均低于全麻组,差异均有统计学意义(P﹤0.05)。术后2、12、24、48 h,复合组患者的VAS评分均明显低于全麻组(P﹤0.01)。术后24、48 h,复合组患者的PCIA泵按压次数和镇痛药物总输注量均明显低于全麻组(P﹤0.01)。复合组患者的苏醒室留置时间、拔管时间、首次下床活动时间、住院时间均明显短于全麻组(P﹤0.01)。复合组患者的麻醉不良反应总发生率明显低于全麻组(P﹤0.01)。结论全麻复合TPVB能够提高胸腔镜肺癌根治术患者的手术麻醉效果及术后镇痛效果,使患者术中血流动力学更加平稳,促进患者术后恢复,降低麻醉不良反应的发生率。
Objective To investigate the anesthetic and postoperative analgesic effects of general anesthesia combined with thoracic paravertebral block(TPVB)in patients undergoing thoracoscopic radical resection of lung cancer.Method According to different anesthesia methods,106 patients undergoing thoracoscopic radical resection of lung cancer were divided into general anesthesia group and compound group,53 patients in each group.The general anesthesia group was treated with simple general anesthesia,while the compound group was treated with general anesthesia combined with TPVB.The operative time and hemodynamic indexes[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)and mean arterial pressure(MAP)]of the two groups were compared.The visual analogue scale(VAS)scores of the two groups were compared at 2,12,24,48 h after surgery,respectively.The times of pressing patientcontrolled intravenous analgesia(PCIA)pump and the total infusion amount of analgesics in the two groups were compared at 24,48 h after surgery.The recovery indexes and incidence of adverse reactions were also compared between the two groups.Result There was no significant difference in operation time between the two groups(P>0.05).The intraoperative SBP,DBP and HR in the two groups were lower than those before the operation,and the MAP in the general anesthesia group was higher than that before the operation,and the differences were statistically significant(P<0.05).The intraoperative SBP,DBP,HR and MAP in the compound group were lower than those in the general anesthesia group,and the differences were statistically significant(P<0.05).The VAS scores of the compound group at 2,12,24,48 h after surgery were lower than those of the general anesthesia group,and the differences were statistically significant(P<0.01).The times of pressing PCIA pump and the total infusion amount of analgesics in compound group at 24,48 h after surgery were lower than those in general anesthesia group,and the differences were statistically significant(P<0.
作者
李军仕
安静
宋红伟
苏孟勤
LI Junshi;AN Jing;SONG Hongwei;SU Mengqin(Department of Surgical Anaesthesia,He’nan Provincial Hospital,Zhengzhou 450000,He’nan,China)
出处
《癌症进展》
2021年第10期1019-1022,共4页
Oncology Progress
关键词
胸腔镜
肺癌根治术
全身麻醉
胸椎旁神经阻滞
术后镇痛
thoracoscopy
radical resection of lung cancer
general anesthesia
thoracic paravertebral block
postoperative analgesia
