首页|竖脊肌平面阻滞对胸腔镜下老年肺癌根治术后谵妄及认知功能的影响

竖脊肌平面阻滞对胸腔镜下老年肺癌根治术后谵妄及认知功能的影响

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目的 明确竖脊肌平面阻滞对胸腔镜下肺癌根治术老年患者术后谵妄和认知功能的影响.方法 选取行胸腔镜下肺癌根治术的90例老年患者作为研究对象,随机分为对照组、观察组,每组45例.对照组患者实施常规全身麻醉,观察组患者在全身麻醉前行竖脊肌平面阻滞.对2组患者不同时点的生命体征、阿片类药物用量、镇痛泵按压次数、切口疼痛视觉模拟量表(VAS)评分、认知功能和术后谵妄情况进行比较.结果 在麻醉结束时,观察组患者的平均动脉压(MAP)及心率明显低于对照组(P<0.05).观察组患者手术过程中瑞芬太尼用量、围术期舒芬太尼用量和镇痛泵按压次数均显著少于对照组(P<0.05).在术后6 h、12 h、24 h及48 h,观察组患者的切口疼痛VAS评分显著低于对照组(P<0.05).观察组患者术后6 h及24 h的认知功能评分均显著高于对照组(P<0.05);对照组术后6 h及24 h的谵妄发生率显著高于观察组(P<0.05).结论 竖脊肌平面阻滞可以显著缓解胸腔镜下肺癌根治术老年患者的围术期疼痛状况,减少阿片类药物用量,降低术后谵妄发生率,还可以改善患者术后认知功能,为降低术后精神类疾病发生率提供了一种新思路.
Effect of erector spinae plane block on postoperative delirium and cognitive function in elderly patients with lung cancer undergoing thoracoscopic radical surgery
Objective To investigate the effect of erector spinae plane block on postoperative delirium and cognitive function in elderly patients with lung cancer undergoing thoracoscopic radical surgery.Methods A total of 90 elderly patients with lung cancer underwent thoracoscopic radical surgery were selected and randomly divided into the control group and the observation group,with 45 cases in each group.The patients in the control group were given general anesthesia,while the patients in the observation group were given erector spinae plane block before general anesthesia.The vital signs at different time points,opioid dosage,number of analgesic pump compressions,incision pain visual analogue scale(VAS)score,cognitive function and postoperative delirium of patients between the two groups were compared.Results At the end of anesthesia,the mean arterial pressure(MAP)and heart rate of patients in the observation group were significantly lower than those in the control group(P<0.05).The dosage of remifentanil during operation,sufentanil during perioperative period and number of analgesia pumps compressions of patients in the observation group were significantly less than those in the control group(P<0.05).The incision pain VAS scores 6 hours,12 hours,24 hours and 48 hours after surgery of patients in the observation group were significantly lower than those in the control group(P<0.05).The scores of cognitive function 6 hours and 24 hours after surgery of patients in the observation group were significantly higher than those in the control group(P<0.05);and the incidence of delirium 6 hours and 24 hours after surgery in the control group was significantly higher than those in the observation group(P<0.05).Conclusion Erector spinae plane block can significantly relieve the perioperative pain of elderly patients with lung cancer undergoing thoracoscopic radical surgery,reduce the dosage of opioids and the incidence of postoperative delirium,improve the postoperative cognitive function of patients,which provides a new idea for reducing the incidence of postoperative mental diseases.

erector spinae plane blockthoracoscopic radical resection for lung cancerelderly patientscognitive functionpostoperative delirium

仲明杰、刘勇、陈悦、耿莹、吴浩、戴体俊

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南京医科大学附属宿迁第一人民医院麻醉科,江苏 宿迁 223800

徐州医科大学麻醉药理学教研室,江苏 徐州 221004

竖脊肌平面阻滞 胸腔镜下肺癌根治术 老年患者 认知功能 术后谵妄

2024

局解手术学杂志
重庆市解剖学会,第三军医大学

局解手术学杂志

CSTPCD
影响因子:1.063
ISSN:1672-5042
年,卷(期):2024.33(8)
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