摘要
目的:探讨超声引导胸椎椎旁神经阻滞复合全麻在胸外科手术中的应用.方法:选取2021年1月—2022年9月我院收治的 40例胸外科手术患者为研究对象,随机将其分为对照组和研究组,每组 20例.对照组选择全麻干预治疗,研究组选择超声引导胸椎椎旁神经阻滞复合全麻干预治疗.比较 2组的麻醉效果、不良反应发生率、应激反应指标、血清炎性因子水平、血流动力学指标.结果:研究组术后自主呼吸时间、清醒时间、气管拔管时间均短于对照组,不良反应发生率低于对照组,组间差异有统计学意义(P＜0.05);干预后,2组VAS评分、AMT评分均低于干预前,且研究组低于对照组,研究组Romsqy 评分高于对照组,差异有统计学意义(P＜0.05);术后 4、12、24 h,2组皮质醇、血糖、血管紧张素水平均低于术前,且研究组低于对照组,差异有统计学意义(P＜0.05);研究组TNF-α、IL-6 水平低于对照组,PGE2 水平高于对照组,组间差异有统计学意义(P＜0.05);麻醉前(T0),2组的HR、MAP、SBP、DBP水平对比,组间差异无统计学意义(P＞0.05);T1～3,研究组HR、MAP、SBP、DBP水平均低于对照组,组间差异有统计学意义(P＜0.05).结论:超声引导胸椎椎旁神经阻滞复合全麻在胸外科手术中的应用效果更加显著,可以有效改善患者的麻醉效果,稳定血压、心率以及血清PGE2、IL-6 水平,减少不良反应的发生,缩短苏醒时间,减轻患者疼痛程度,改善认知功能障碍,提高镇静效果及血管内皮功能,值得临床推广.
Abstract
Objective:Exploring the application of ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia in thoracic surgery.Methods:40 thoracic surgery patients admitted to our hospital from January 2021 to September 2022 were selected as the research subjects,randomly divided them into a control group and a study group,with 20 cases in each group.The control group chose general anesthesia intervention treatment,while the study group chose ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia intervention treatment.The anesthesia effects,incidence of adverse reactions,stress response indicators,serum inflammatory factor levels,and hemodynamic indicators between two groups were compared.Results:The study group had shorter postoperative spontaneous breathing time,wakefulness time,and tracheal extubation time compared to the control group,and the incidence of adverse reactions was lower than that of the control group,the differences between groups were statistically significant(P＜0.05).After intervention,the VAS score and AMT score of both groups were lower than before intervention,and the study group was lower than the control group,the Ramsay score of the study group was higher than that of the control group,the differences were statistically significant(P＜0.05).At 4,12 and 24 h after surgery,the average levels of cortisol,blood glucose,and angiotensin water in the two groups were lower than before surgery,and the study group was lower than the control group,the differences was statistically significant(P＜0.05).Research group TNF-α、IL-6 levels are lower than the control group,while PGE2 levels are higher than the control group,the differences between groups were statistically significant(P＜0.05).Comparison of HR,MAP,SBP,and DBP levels between two groups before anesthesia(T0),there was no statistically significant difference between groups(P＞0.05).T1～T3,the levels of HR,MAP,SBP,and DBP in the study group were lower than those in the control group,the differences between groups were statistically significant(P＜0.05).Conclusion:The application effect of ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia in thoracic surgery is more significant,which can effectively improve the anesthesia effect of patients,stabilize blood pressure,heart rate,serum PGE2 and IL-6 levels,reduce the occurrence of adverse reactions,shorten awakening time,alleviate patient pain,improve cognitive dysfunction,enhance sedation effect and vascular endothelial function,and is worthy of clinical promotion.
国家科技期刊平台
NSTL
万方数据