摘要
目的:观察右美托咪定联合罗哌卡因肋间神经阻滞在胸腔镜肺癌根治术患者术后镇痛中的应用效果。方法:选取2024年1—9月于该院行胸腔镜肺癌根治术的85例患者进行前瞻性研究,按照随机数字表法将其分为对照组42例与研究组43例。对照组采用罗哌卡因肋间神经阻滞,研究组在对照组基础上联合右美托咪定肋间神经阻滞。比较两组术后不同时间镇痛[视觉模拟评分法(VAS)]、镇静(Ramsay镇静评分)评分,手术前后应激指标[皮质醇(Cor)、肾上腺素(E)]水平、认知功能[简易精神状态量表(MMSE)]评分,以及不良反应发生率。结果:术后4、12 h,研究组VAS评分均低于对照组,Ramsay镇静评分均高于对照组,差异有统计学意义(P<0.05);术后,两组Cor、E水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后24 h,两组MMSE评分均低于术前,但研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:右美托咪定联合罗哌卡因肋间神经阻滞应用于胸腔镜肺癌根治术患者术后镇痛可提高镇痛、镇静效果,减轻应激反应,改善认知功能,效果优于单纯罗哌卡因肋间神经阻滞。
Objective:To observe effects of Dexmedetomidine combined with Ropivacaine intercostal nerve block on postoperative analgesia in patients undergoing thoracoscopic radical resection of lung cancer.Methods:A prospective study was conducted on 85 patients who underwent thoracoscopic radical resection of lung cancer in this hospital from January to September 2024.According to the random number table method,they were divided into control group(42 cases)and study group(43 cases).The control group was treated with Ropivacaine intercostal nerve block,while the study group was combined with Dexmedetomidine intercostal nerve block on the basis of that of the control group.The analgesia[visual analogue scale(VAS)]and sedation(Ramsay sedation score)scores at different time after the surgery,the stress indicators[cortisol(Cor),epinephrine(E)]levels and the cognitive function[mini-mental state examination(MMSE)]scores before and after the surgery,and the incidence of adverse reactions were compared between the two groups.Results:4 and 12 h after the surgery,the VAS scores of the study group were lower than those of the control group,the Ramsay sedation scores were higher than those of the control group,and the differences were statistically significant(P<0.05).After the surgery,the levels of Cor and E in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).24 h after the surgery,the MMSE scores of the two groups were lower than those before the surgery,but that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Dexmedetomidine combined with Ropivacaine intercostal nerve block for postoperative analgesia in the patients undergoing thoracoscopic radical resection of lung cancer can improve analgesic and sedative effects,reduce the stress response,and improve the cognitive function.Moreover,it is superior to simple Ropivacaine intercostal nerve block.
作者
张娇娇
韩磊
郝丹宁
ZHANG Jiaojiao;HAN Lei;HAO Danning(Anesthesia and Surgery Center of Jiaozuo People’s Hospital,Jiaozuo 454000 Henan,China)
出处
《中国民康医学》
2026年第1期51-54,共4页
Medical Journal of Chinese People’s Health
关键词
胸腔镜肺癌根治术
右美托咪定
罗哌卡因
肋间神经阻滞
术后
镇痛
镇静
应激反应
Thoracoscopic radical resection of lung cancer
Dexmedetomidine
Ropivacaine
Intercostal nerve block
Postoperative
Analgesia
Sedation
Stress response
