摘要
目的分析超声引导下开展竖脊肌阻滞麻醉对于开胸手术的作用。方法选择80例开胸手术患者,随机数字表分组,治疗组40例采取超声引导下的竖脊肌阻滞麻醉联合静脉麻醉,对照组40例采取全凭静脉麻醉,对比麻醉效果。结果两组患者在入室时(T_(0))对比平均动脉压(MAP)与心率(heart rate,HR)水平差异无统计学意义(P>0.05)。治疗组在切皮时(T_(1))、单肺通气时(T_(2))、肋骨撑开即刻(T_(3))、缝皮时(T4)的MAP与HR指标均低于对照组,差异具有统计学意义(P<0.05)。治疗组的组间的康复指标均短于对照组,差异具有统计学意义(P<0.05)。术后不同时间点,治疗组在静息与咳嗽状态下的疼痛评分均低于对照组,治疗组的呼吸频率(RR)高于对照组,差异具有统计学意义(P<0.05)。治疗组的血氧饱和度(SpO_(2))水平接近于对照组(P>0.05)。术前,对比组间的炎性介质水平差异无统计学意义(P>0.05)。术后24 h,治疗组的炎性介质水平优于对照组,差异具有统计学意义(P<0.05)。结论超声引导下开展竖脊肌阻滞麻醉可以稳定患者体征,缩短术后康复时间,且能缓解术后痛感,减轻机体炎性反应。
Objective The effect of ultrasound-guided anesthesia for erector spinal muscle block on thoracotomy was analyzed.Methods Eighty patients with thoracotomy surgery were selected and grouped in random numbers.In treatment group,40 patients received ultrasound-guided erector spinal block anesthesia combined with intravenous anesthesia,and 40 patients in control group received all-intravenous anesthesia to compare the anesthesia effect.Results There was no difference in mean arterial pressure(MAP)and heart rate(HR)levels at home entry(T_(0))(P>0.05).The MAP and HR measures in the treatment group(T_(1)),single lung ventilation(T_(2)),rib opening immediate(T_(3)),and suture(T4)were lower than those of the control group,and the difference was statistically significant(P<0.05).All the treatment groups were shorter than the control group,and the difference was statistically significant(P<0.05).At different time points,the pain score was lower than the control group,and the respiratory rate(RR)was higher than the control group,and the difference was statistically significant(P<0.05).The SpO_(2)level in the treatment group was close to that in the control group(P>0.05).Before surgery,there was no difference in inflammatory mediator levels between the comparison groups(P>0.05).At 24 hours after surgery,the level of inflammatory mediators in the treated group was better than that in the control group,which was statistically significant(P<0.05).Conclusion Ultrasound-guided erector spinal muscle block anesthesia can stabilize the patient′s physical signs,shorten the postoperative rehabilitation time,relieve the postoperative pain,and reduce the inflammatory reaction of the body.
作者
韦惠
谭新梅
蓝英年
WEI Hui;TAN Xinmei;LAN Yingnian(Department of Anesthesiology,Hechi People′s Hospital,Hechi Guangxi 547000,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第9期1206-1210,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
广西河池市科学研究与技术开发计划项目(编号:B1824-10)。
关键词
超声引导
竖脊肌阻滞
开胸手术
疼痛评分
炎性介质
麻醉效果
Ultrasound guidance
Erector spinal muscle block
Thoracotomy
Pain score
Inflammatory mediators
Anesthetic effect
