摘要
目的:研究婴儿胸腔镜手术采用肋间神经阻滞技术联合静脉舒芬太尼镇痛的镇痛作用。方法:60例婴儿拟行电视胸腔镜下肺叶楔形切除术,采用随机数字表法分为:肋间神经阻滞技术+静脉舒芬太尼镇痛组(A组),静脉舒芬太尼镇痛组(B组)。肋间神经阻滞操作在关胸前15 min于胸腔镜直视下进行,A组患儿各注入1 ml的0.1%罗哌卡因注射液,B组患儿各注入1ml的生理盐水。胸腔镜手术结束后,两组患儿静脉舒芬太尼镇痛泵配方相同。记录患儿拔出气管导管时(T0)、拔出气管导管后6 h(T1)、12 h(T2)、24 h(T3)的疼痛评分,并记录T1、T2、T3各个时刻PCIA泵的按压次数及24 h的总按压次数,记录患儿是否发生抑制呼吸、呕吐等副作用。结果:在T0、T1两个时间段,患儿镇痛评分A组较B组显著降低(P<0.05);其余时间段,AB两组比较无统计学差异。T1时间段,PCIA泵按压次数A组患儿较B组患儿显著降低(P<0.05);但其余时间段,AB两组比较无统计学差异。24 h镇痛泵总按压次数A组患儿较B组患儿显著降低(P<0.05)。抑制呼吸、呕吐等不良反应AB两组患儿均未出现。结论:婴儿胸腔镜手术采用肋间神经阻滞技术联合静脉舒芬太尼镇痛安全、有效。
Objective:To study the analgesic effect and safety of intercostal nerve block combined with intravenous sufentanil analgesia in infants undergoing thoracoscopic surgery.Methods:60 infants who underwent video-assisted thoracoscopic pulmonary wedge resection were divided into two groups by random number table method:intercostal nerve block combined with intravenous sufentanil analgesia group(group A)and intravenous sufentanil analgesia group(group B).Intercostal nerve block was performed under thoracoscopic direct vision 15 minutes before chest closure.The infants in group A were injected with 0.1%ropivacaine injection of 1 ml,while those in group B were injected with 1 ml of saline,both groups received the same sufentanil intravenous analgesia pump.The pain scores of infants at extubation(T0),6 hours(T1),12 hours(T2)and 24 hours(T3)after extubation were recorded.The pressing times of PCIA pump at each time of T1,T2,T3 and the total pressing times at 24 hours were recorded.Side effects such as vomiting and respiratory depression were recorded.Results:In T0 and T1,the pain score of group A was significantly lower than that of group B(P<0.05),and there was no significant difference in the analgesic score between the two groups in the rest of the time.In T1 period,the pressing times of analgesic pump in group A were significantly lower than in group B(P<0.05),but there was no significant difference during the rest of the time.The total pressing times of 24-hour analgesic pump in group A were significantly lower than those in group B.Side effects such as respiratory depression and vomiting did not occur in both groups.Conclusion:Intercostal nerve block combined with intravenous analgesia is safe and effective for infants undergoing thoracoscopic surgery.
作者
陈祥楠
杨世辉
刘晶
黄微
罗超荣
李敏
何健珊
胡祖荣
Chen Xiangnan;Yang Shihui;Liu Jing;Huang Wei;Luo Chaorong;Li Min;He Jianshan;Hu Zurong(Department of Anesthesiology,Guangdong Women and Children's Hospital,Guangzhou 510010,China)
出处
《广州医科大学学报》
2019年第2期29-32,共4页
Academic Journal of Guangzhou Medical University
基金
广东省科技计划项目(2016A020215127)
关键词
肋间神经
阻滞
胸腔镜
婴儿
镇痛
intercostal nerve
block
thoracoscopic surgery
infant
analgesia
