超声引导下胸椎旁神经阻滞在胸腔镜肺叶切除术患者术后镇痛中的应用效果被引量：7

Ultrasound-guided Thoracic Paravertebral Nerve Block for Postoperative Analgesia in Patients undergoing Thoracoscopic Lobectomy

暂未订购

导出

摘要目的评价超声引导下胸椎旁神经阻滞对胸腔镜肺叶切除术患者术后镇痛的效果。方法选取2017年5月至2017年12月我院胸外科择期行胸腔镜肺叶切除术60例患者作为研究对象,采用随机数字表法将其分为超声引导下胸椎旁神经阻滞复合全麻组(T组)和连续硬膜外麻醉复合全麻组(E组),每组30例。T组患者在超声引导下于T5水平行胸椎旁神经阻滞,注射0.5%罗哌卡因+5 mg地塞米松共30 mL;E组于T4~5间隙行硬膜外穿刺置管,手术结束前30 min硬膜外注射0.125%罗哌卡因5 mL,之后连接镇痛泵0.2%罗哌卡因4 mL/h,患者自控镇痛(PCA)量2 mL,锁定时间15 min。两组患者均复合全凭静脉麻醉,分析临床效果。结果术后24 h、48 h静息和运动的VAS评分两组差异无统计学意义(P>0.05)。T组术后48 h地佐辛用量少于E组,T组术后第一次下床活动时间、术后住院时间短于E组,差异有统计学意义(P<0.05)。结论超声引导下胸椎旁神经阻滞复合全麻可有效缓解胸腔镜肺叶切除术患者术后疼痛,减少术后24 h内地佐辛用量,有利于患者早期康复。

作者韩志国贾衍杰张良常毅 HAN Zhi-guo;JIA Yan-jie;ZHANG Liang

机构地区辽宁省大连市中心医院麻醉科

出处《中国医药指南》 2020年第6期21-22,共2页 Guide of China Medicine

关键词超声胸椎旁神经阻滞胸腔镜术后镇痛

分类号 R614 [医药卫生—麻醉学]

引文网络
相关文献

参考文献2

1章蔚,李娟,耿擎天,王松,康芳,潘建辉,柴小青.单点或多点胸椎旁神经阻滞在胸腔镜肺叶切除患者术后镇痛的临床研究[J].临床麻醉学杂志,2014,30(2):109-113. 被引量：53
2陈冀衡,范志毅,杨奕,潘振宇,毕素萍,张廷岭.胸椎旁阻滞对开胸患者开胸前心功能及术后情况的影响[J].临床麻醉学杂志,2008,24(3):197-199. 被引量：5

二级参考文献18

1张骍,李兴福,耿智隆,王公校,殷裕雄,陈烨,方敏霞.全麻加胸椎旁阻滞和全麻加硬膜外阻滞对开胸患者血流动力学的影响[J].西北国防医学杂志,2005,26(3):222-223. 被引量：3
2Eng J,Sabanathan S. Site of action of continuous extrapleural intercostal nerve block. Ann Thorac Surg, 1991,51:387-389.
3Sageman WS, Riffenburgh RH,Spiess BD. Equivalence of bioimpedance and theromodilution in mearsuring cardiac index after cardiac surgery. J Cardiothoracic Vase Anesth, 2002,16: 8-14.
4Heller AR, Lity RJ, Dionlagic I, et al. Combined anesthesia with epidural catheter A retrospective analysis of the perioperative course in patients ungoing radial prostatectomy, Anaesthesist, 2000,49:949-959.
5Cheema SP, Ilsley D, Richardson J, et al. A thermographic study of paravertbral analgesia. Anaesthesia, 1995, 50:118-121.
6Daly DJ,Myles PS. Update on the role of paravertebral blocks for thoracic surgery:are they worth it[J].Curr Opin Anaesthesiol,2009,(01):38-43.
7Hara K,Sakura S,Nomura T. Ultrasound guided thoracic paravertebral block in breast surgery[J].{H}ANAESTHESIA,2009,(02):223-225.
8Kaya FN,Turker G,Mogol EB. Thoracic paravertebral block for video-assisted thoracoscopic surgery:single injection versus multiple injections[J].{H}Journal of Cardiothoracic and Vascular Anesthesia,2012,(01):90-94.
9Kaya FN,Turker G,Basagan-Mogol E. Preoperative multiple injection thoracic paravertebral blocks reduce postoperative pain and analgesic requirements after video-assisted thoracic surgery[J].{H}Journal of Cardiothoracic and Vascular Anesthesia,2006,(05):639-643.
10Hill SE,Keller RA,Stafford-Smith M. Efficacy of single-dose,multilevel paravertebral nerve blockade for analgesia after thoracoscopic procedures[J].{H}ANESTHESIOLOGY,2006,(05):1047-1053.