摘要
目的探讨胸腔镜手术应用超声引导下胸椎旁神经阻滞(TPVB)的镇痛效果及对患者神经功能的影响。方法将2020年3月—2021年3月该院收治的74例行胸腔镜手术治疗患者随机分为对照组(n=37)和研究组(n=37),对照组单纯采用全身麻醉,研究组采用全麻复合TPVB麻醉,比较两组镇痛效果、神经功能指标及不良反应情况。结果研究组术后1、4、16 h的视觉模拟疼痛(VAS)评分分别为(2.13±0.68)分、(2.07±0.71)分、(2.26±0.77)分均低于对照组,静脉自控镇痛(PCIA)泵总用药量(73.46±4.28)mL少于对照组,两组比较差异有统计学意义(t=10.785、8.794、5.137、5.989,P<0.05);研究组术后血清神经元特异性烯醇化酶(NSE)、S100β蛋白含量水平分别为(10.14±4.27)、(1.48±0.79)μg/L均低于对照组,差异有统计学意义(t=5.573、7.827,P<0.05);研究组不良反应发生率5.41%低于对照组24.32%,差异有统计学意义(χ^(2)=5.232,P<0.05)。结论胸腔镜手术应用全麻复合TPVB麻醉有助于稳定患者生命体征,改善术后镇痛效果,同时对患者的中枢神经可发挥一定的保护作用,安全性高。
Objective To investigate the analgesic effect of ultrasound-guided thoracic paravertebral nerve block(TPVB)and its influence on patients'neurological function in thoracoscopic surgery.Methods From March 2020 to March 2021,74 patients undergoing thoracoscopic surgery were randomly divided into a control group(n=37)and a study group(n=37).The control group was given general anesthesia alone,and the study group was given general anesthesia combined with TPVB anesthesia.The analgesic effect,neurological function indexes and adverse reactions of the two groups were compared.Results The visual analogue pain(VAS)scores of the study group were(2.13±0.68)points,(2.07±0.71)points,and(2.26±0.77)points at 1 h,4 h,and 16 h after operation,respectively,were lower than those of the control group.The total dosage of PCIA pump(73.46±4.28)mL was less than that of the control group,and the difference between the two groups was statistically significant(t=10.785,8.794,5.137,5.989,P<0.05).The postoperative serum neuron-specific enolase(NSE)and S100βprotein levels of the study group were(10.14±4.27)μg/L and(1.48±0.79)μg/L respectively lower than those of the control group.The difference was statistically significant(t=5.573,7.827,P<0.05).The incidence of adverse reactions in the study group was 5.41%lower than that in the control group 24.32%,the difference was statistically significant(χ^(2)=5.232,P<0.05).Conclusion The application of general anesthesia combined with TPVB anesthesia in thoracoscopic surgery can help stabilize patients'vital signs and improve postoperative analgesia.At the same time,it can play a certain protective effect on the patient's central nervous system,with high safety.
作者
宋琳苑
吴国超
SONG Linyuan;WU Guochao(Department of Anesthesiology,Guangdong Meizhou Traditional Chinese Medicine Hospital,Meizhou,Guangdong Province,514071 China)
出处
《世界复合医学》
2021年第11期54-57,共4页
World Journal of Complex Medicine
关键词
胸腔镜手术
超声引导
胸椎旁神经阻滞
镇痛效果
神经功能
Thoracoscopic surgery
Ultrasound guidance
Thoracic paravertebral nerve block
Analgesic effect
Nerve function
