摘要
目的观察超声或神经刺激器引导的胸椎旁神经阻滞应用于开胸手术的麻醉效果及对血流动力学的影响。方法择期肺癌根治术患者60例,随机分为3组,每组各20例,超声引导胸椎旁神经阻滞复合全麻组(U组)、神经刺激器引导胸椎旁神经阻滞复合全麻组(S组)和徒手胸椎旁神经阻滞复合全麻组(B组),全麻诱导前分别行TPVB(T4-5);记录阻滞平面、成功率及并发症,观察注药后血流动力学变化,30min后开始全麻诱导。结果 U组或S组TPVB(T4-5)范围为术侧T2～T8,成功率达95%,无其他并发症,B组成功率达85%,TPVB对MAP和HR无明显影响。结论超声或神经刺激器引导的椎旁神经阻滞操作简单,阻滞平面广,成功率高,并发症少,适用于开胸手术中的麻醉镇痛。
Objective To observe the anaesthetic effect of ultrasound or nerve - stimulator guided thoracic paravertebral block in thoracotomy, as well as its impact on haemodynamics. Methods Sixty eases undergoing selective radical resec- tion for lung cancer, were randomly divided into 3 groups, 20 eases for each： group U （ ultrasound guided TPVB com- bined with general anesthesia ）, group S （ nerve - stimulator guided TPVB combined with general anesthesia） and group B （barehands TPVB combined with general anesthesia group）. TPVB （T4 -5）was performed on sixty patients before gen- eral anesthesia. The dermatomes of intercostal nerve block, success rate and complications were rocorded, and hemody- namics was observed. The general anesthesia was induced 30 minutes later. Results The success rate was up to 95% in group U or group S（ from T4 to T8 ） and no other complications occurred. The success rate was 85% in group B. TPVB had on obvious influence on mean artery pressure （MAP） and heart rate （HR）. Conclusions Ultrasound or nerve - stim- ulator guided thoracic paravertebral block is easy to perform, provides wide dermatomes of intercostal nerve block, has a higher success rate and less complications, which is applicable to anaesthesia in thoraeotomy.
出处
《社区医学杂志》
2013年第12期33-35,共3页
Journal Of Community Medicine
