首页|不同神经阻滞方案对单孔胸腔镜手术围术期的镇痛效果分析

不同神经阻滞方案对单孔胸腔镜手术围术期的镇痛效果分析

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目的 分析不同神经阻滞方案对单孔胸腔镜手术围术期的镇痛效果.方法 选取2020年6月—2022年6月于我院行单孔胸腔镜手术治疗的80例患者.根据入院时间的先后顺序将其分为对照组和观察组,每组各40例.对照组采用超声引导下椎旁神经阻滞,观察组采用改良前锯肌阻滞.对比两组围术期不同时间节点的疼痛评分、手术时间、舒芬太尼和瑞芬太尼用量、不良反应发生率.结果 两组围术期不同时间节点的疼痛评分、手术时间比较,差异均无统计学意义(t=1.072、0.637、0.657、1.803、0.650、0.439、1.399、1.277、1.548,均P>0.05);而观察组舒芬太尼和瑞芬太尼用量均低于对照组,两组比较差异均有统计学意义(t=5.869、5.090,均P<0.05);观察组不良反应发生率低于对照组,两组比较差异有统计学意义(x2=5.165,P<0.05).结论 单孔胸腔镜手术患者采用超声引导下椎旁神经阻滞或改良前锯肌阻滞在围术期镇痛效果方面无显著差异,相比于椎旁神经阻滞而言,改良前锯肌阻滞在术中使用麻醉药物的剂量更少,可减小对术中循环的影响,术后不良反应轻微,值得推广.
Analysis of analgesic effects of different neural blockade protocols during perioperative period of single-port thoracoscopic surgery
Objective To analyze the analgesic effect of different neural blockade schemes during perioperative single-port thoracoscopic surgery.Methods A total of eighty patients who underwent single-port thoracoscopic surgery in our hospital from June 2020 to June 2022 were selected.Based on the order of their admission time,they were divided into a control group and an observation group,with 40 patients in each group.The control group received ultrasound-guided paravertebral nerve blockade,while the observation group underwent modified serratus anterior muscle blockade.Comparisons were made between the two groups regarding pain scores at different perioperative time points,operation time,sufentanil and remifentanil dosages,and the incidence of adverse reactions.Results There was no statistically significant difference in pain scores at various perioperative time points and operation time between the two groups(t=1.072,0.637,0.657,1.803,0.650,0.439,1.399,1.277,1.548,all P>0.05).However,the doses of sufentanil and remifentanil in the observation group were lower than those in the control group,the differences were statistically significant(t=5.869,5.090,all P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(x2=5.165,P<0.05).Conclusion For patients undergoing single-port thoracoscopic surgery,there is no significant difference in perioperative analgesic effects between ultrasound-guided paravertebral nerve blockade and modified serratus anterior muscle blockade.Compared to the paravertebral nerve blockade,the modified serratus anterior muscle blockade requires a lesser dose of anesthetic drugs during the surgery,thus reducing its impact on intraoperative circulation.Postoperative adverse reactions are also milder with this method,making it worth promoting.

Single-port thoracoscopic surgeryUltrasound guidanceParavertebral nerve blockadeModified serratus anterior muscle blockade

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甘肃省张掖市第二人民医院麻醉与围手术期医学科,甘肃 张掖 734100

单孔胸腔镜手术 超声引导 椎旁神经阻滞 改良前锯肌阻滞

2024

中国冶金工业医学杂志
鞍山钢铁(集团)公司

中国冶金工业医学杂志

影响因子:0.268
ISSN:1005-5495
年,卷(期):2024.41(1)
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