摘要
目的分析胸椎旁神经阻滞(TPVB)复合全麻在非体外循环冠状动脉旁路移植术(OPCABG)患者中的临床应用效果。方法选择行OPCABG的患者100例,按照麻醉方式均分为全麻组(全麻手术)与联合组(TPVB复合全麻手术),比较两组手术前后应激指标、疼痛水平、术后恢复时间、认知功能以及不良反应发生情况。结果与术前比较,两组术后1天NE、Cor、ACTH及术后1、3天VAS评分升高,且联合组低于全麻组(P<0.05)。与术前比较,两组术后MoCA评分均降低,术后1天最低;且联合组术后高于全麻组(P<0.05)。联合组术后ICU停留时间、术后首次排气时间、住院时间均低于全麻组(P<0.05)。两组不良反应发生率比较差异无显著性(P>0.05)。结论对OPCABG患者使用TPVB复合全麻麻醉更能有效提升镇痛效果,减轻术后应激反应,促进恢复。
Aim To analyze clinical effect of thoracic paravertebral block(TPVB)combined with general anesthesia in patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods According to different anesthesia methods,100 patients undergoing OPCABG were divided into general anesthesia group(general anesthesia)and combination group(TPVB combined with general anesthesia).Stress indexes,pain level,postoperative recovery time,cognitive function and occurrence of adverse reactions were compared between the two groups before and after surgery.Results Compared with preoperative baselines,NE,Cor and ACTH at 1d after surgery,and VAS scores at 1 d and 3 d after surgery,were increased in both groups,and these parameters were lower in combination group than general anesthesia group(P<0.05).MoCA scores were decreased in both groups after surgery,and the scores were the lowest at 1d after surgery.Furthermore,MoCA score in combination group was higher than that in general anesthesia group(P<0.05).The postoperative stay time in ICU,first exhaust time and length of hospital stay in combination group were shorter than those in general anesthesia group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion TPVB combined with general anesthesia can more effectively improve analgesic effect,relieve postoperative stress response and promote recovery in OPCABG patients.
作者
王艳丽
王梦迪
张志润
何会珍
WANG Yanli;WANG Mengdi;ZHANG Zhirun;HE Huizhen(Department of Anesthesiology,Baoding NO.2 Central Hospital,Baoding 072750,Hebei,China)
出处
《中南医学科学杂志》
2025年第3期439-441,445,共4页
Medical Science Journal of Central South China
基金
河北省医学科学研究课题(20241636)。
