摘要
目的探讨超声引导下胸椎旁神经阻滞(TPVB)用于肋骨骨折手术患者术后镇痛的效果。方法回顾性纳入2019年1月至2021年6月河南省省立医院收治的79例肋骨骨折手术患者,均行全身麻醉,将术后使用TPVB镇痛的患者设为A组(40例),将术后使用静脉镇痛棒镇痛的患者设为B组(39例)。比较两组患者术后不同时间的视觉模拟评分法(VAS)评分、术后肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)]变化,以及术后不良反应发生率。结果术后12、24、48 h,A组VAS评分均低于B组(P均<0.05)。术后第3天,A组FEV1和FVC均高于B组(P均<0.05)。A组术后不良反应发生率(7.50%,3/40)低于B组(25.64%,10/39),P<0.05。结论在肋骨骨折术后实行TPVB镇痛,具有较好的镇痛效果和较低的不良反应发生率,且可以有效促进肺通气功能的恢复,安全性较高。
Objective To investigate the effect of ultrasound-guided thoracic paravertebral block(TPVB)on postoperative analgesia after rib fractures surgery.Methods Seventy-nine patients who underwent rib fracture surgery in Henan Provincial Hospital from January 2019 to June 2021 were retrospectively included,all of whom underwent general anesthesia.Patients who received postoperative TPVB analgesia were set as group A(40 cases),and patients who received postoperative intravenous analgesia pump were set as group B(39 cases).The visual analogue scale(VAS)score,postoperative pulmonary function assessed by forced expiratory volume in 1 second(FEV1)and forced vital capacity(FVC)at different times after surgery were compared between the two group;and the incidence of postoperative adverse reactions were compared between the two groups.Results At 12,24,and 48 hours after surgery,the VAS score of group A was lower than that of group B(all P<0.05).On the 3rd day after operation,the levels of FEV1 and FVC in group A were higher than those in group B(all P<0.05).The incidence of postoperative adverse reactions in group A(7.50%,3/40)was lower than that in group B(25.64%,10/39),P<0.05.Conclusions TPVB analgesia after rib fracture surgery has better analgesic effects and lower incidence of adverse reactions,and can effectively promote the recovery of pulmonary ventilation function,with higher safety.
作者
王卫萍
李军仕
Wang Weiping;Li Junshi(Department of Anesthesiology,Henan Provincial Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2023年第10期29-31,共3页
Chinese Journal of Practical Medicine
关键词
全身麻醉
肋骨骨折
胸椎旁神经阻滞
镇痛
Anesthesia,general
Rib fractures
Thoracic paravertebral block
Analgesia
