摘要
目的研究ICB在单孔胸腔镜手术后早期的镇痛效果。方法根据纳入和排除标准,收集2023年1月-2024年1月本院心胸外科行单孔胸腔镜手术的患者60例;采用随机对照的方法,按随机表顺序将入组患者分为观察组和对照组各30例。手术结束后在关闭胸腔前,观察组用0.375%罗哌卡因20mL行胸腔镜直视下ICB,对照组不做局部镇痛。术毕2组患者均采用患者PCIA,记录观察组与对照组患者术后1h、6h、12h、18h、24h静息和咳嗽时VAS疼痛评分,记录PCIA首次按压时间、24h内总按压次数及补救镇痛次数;记录24h内恶心、呕吐、皮肤瘙痒、嗜睡、不良反应的发生情况。结果2组患者一般资料和术后24h静息和咳嗽时VAS评分、不良反应发生率对比,差异无统计学意义(P>0.05)。与对照组比较,观察组术后1h、6h、12h、18h安静和咳嗽时VAS疼痛评分降低,PCIA首次按压时间晚、采取补救镇痛少,差异有统计学意义(P<0.05)。结论胸腔镜直视下肋间神经阻滞操作简便,能有效缓解单孔胸腔镜手术后的早期疼痛,不良反应少。
Objective To study the analgesic effect of thoracoscopic direct intercostal nerve block(ICB)in the early stage after single-hole thoracoscopic surgery.Methods According to the inclusion and exclusion criteria,60 patients who underwent single-hole thoracoscopic surgery in the Department of Cardiothoracic Surgery of our hospital from January 2023 to January 2024 were collected;By using the random control method,the enrolled patients were divided into the observation group and the control group in the order of the random table,with three cases in each group.After the operation,before closing the chest cavity,the observation group performed ICB under direct thoracoscopic vision with 0.375%ropivacaine 20mL,and the control group did not received local analgesia.At the end of the operation,patients in both groups were treated with patient-controlled intravenous analgesia pump(PCIA),the VAS pain scores of patients in the observation group and the control group at rest and during coughing at 1h,6h,12h,18h,and 24h after the operation were recorded.The first pressure time of PCIA,the total number of compressions within 24 hours and the number of remedial analgesia were also recorded;The occurrences of adverse reactions,such as nausea,vomiting,itching of the skin,and sleepiness within 24 hours were recorded.Results There was no statistically significant difference in the general information of the two groups of patients,the VAS scores at rest and during coughing 24h after surgery,and the incidence of adverse reactions(P>0.05).Compared with the control group,the VAS pain scores of the observation group were lower at 1h,6h,12h,and 18h after surgery when at rest and coughing.The first compression time of PCIA was later and less remedial analgesia was taken,the differences were statistically significant(P<0.05).Conclusions Intercostal nerve block under direct vision of thoracoscopy is easy to operate and can effectively relieve the early pain after single-port thoracoscopic surgery,and has fewer adverse reactions.
作者
马丽
曹蔚
王繁静
马丹
王政
肖建峰
卢迅来
朱均伟
王振
MA Li;CAO Wei;WANG Jingfan;MA Dan;WANG Zheng;XIAO Jianfeng;LU Xunlai;ZHU Junwei;WANG Zhen(Department of Cardiothoracic Surgery,Northeast Yunnan Central Hospital,Zhaotong Yunnan 657000,China)
出处
《云南医药》
2025年第6期30-33,共4页
Medicine and Pharmacy of Yunnan
关键词
单孔胸腔镜
肋间神经阻滞
术后镇痛
single-port thoracoscopy
intercostal nerve block
postoperative analgesia
