摘要
目的观察超声引导下胸椎旁间隙镇痛法在胸腔镜肺癌根治术患者术后镇痛中的应用效果。方法选择62例胸腔镜肺癌根治术患者作为研究对象,行静吸复合全麻进行术后镇痛的31例患者作为对照组,静吸复合全麻基础上超声引导下胸椎旁间隙神经阻滞的31例患者作为观察组,比较两组术后2、24、48 h时视觉模拟评分(VAS),24 h启动自控按钮次数、输注总量、胸腔引流管留置时间,肺功能,不良反应。结果观察组术后2、24 h VAS评分显著低于对照组(P<0.05),术后48 h两组VAS评分差异无统计学意义(P>0.05)。观察组术后24 h启动自控按钮次数、输注总量、胸腔引流管留置时间均显著少于对照组(P<0.05)。术后48 h观察组的肺功能指标用力肺活量(VC),1s用力呼气容量(FEV1),最大呼气中段流量(MMF),每分钟最大通气流量(MVV)均显著优于对照组(P<0.05)。观察组、对照组不良反应发生率分别为9.7%、16.1%,组间差异无统计学意义(P>0.05)。结论超声引导下胸椎旁间隙镇痛法在胸腔镜肺癌根治术患者术后镇痛中的应用效果满意,能够减轻患者术后疼痛,减少启动自控按钮次数、输注总量,改善术后肺功能,是安全、有效的镇痛方法。
Objective To compare the observation of application effect of ultrasound-guided paravertebral space analgesia in patients undergoing thoracoscopic radical resection of lung cancer.Methods 62 patients undergoing thoracoscopic radical resection of lung cancer were selected as the research object,31 patients with intravenous inhalation combined general anesthesia for postoperative analgesia were selected as the control group,31 patients with thoracic paravertebral space nerve block under ultrasound guidance served based on intravenous inhalation combined general anesthesia as the observation group.The visual analogue scale(VAS)at 2,24 and 48 h after surgery,the number of activation of the automatic button at 24 h,the total amount of infusion,the indwelling time of chest drainage tube,lung function,and adverse reactions of the 2 groups were compared.Results The VAS score of the observation group was significantly lower than that of the control group at 2 and 24 h after operation(P<0.05),and there was no significant difference in VAS score between the 2 groups at 48 h after operation(P>0.05).The number of activation of self-control button,the total amount of infusion,and the indwelling time of chest drainage tube in the observation group at 24 hours after operation were significantly less than those of the control group(P<0.05).The lung function indexes of observation group at 48h after operation:forced vital capacity(VC),forced expiratory volume in 1s(FEV1),maximum mid-expiratory flow(MMF)and maximum ventilation flow per minute(MVV)were significantly better than those of the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group were 9.7% and 16.1%,respectively,and there was no statistically significant difference between the 2 groups(P>0.05).Conclusion Ultrasound-guided thoracic paravertebral space analgesia has satisfactory results in postoperative analgesia for patients undergoing thoracoscopic radical resection of lung cancer,it can reduce postoperative pain,reduce
作者
周灿华
屈翰
李孟阳
李兴晓
ZHOU Canhua;QU Han;LI Mengyang(China Pingmei Shenma Group General Hospital,Pingdingshan,467000)
出处
《实用癌症杂志》
2021年第7期1123-1126,共4页
The Practical Journal of Cancer
基金
河南省医学科技攻关计划项目(编号:201808213)。
关键词
肺癌根治术
胸腔镜
胸椎旁间隙神经阻滞
超声引导
镇痛
Radical surgery of lung cancer
Thoracoscopy
Thoracic paravertebral block
Ultrasound-guided
Analgesia
