全麻复合胸椎椎旁神经阻滞对胸腔镜手术患者镇痛效果及术中镇痛药用量的影响
Effect of General Anesthesia Combined with Thoracic Paravertebral Nerve Block on Analgesic Effect and Intraoperative Analgesic Dosage in Patients Undergoing Thoracoscopic Surgery
陈静1
作者信息
- 1. 350000 福建福州,福建省福州肺科医院麻醉科
- 折叠
摘要
目的 研讨全麻复合胸椎椎旁神经阻滞(Thoracic Paravertebral Nerve Block,TPVB)对胸腔镜手术患者镇痛效果及术中镇痛药用量的影响.方法 选取2022年2月至10月在福建省福州肺科医院行胸腔镜手术的患者60例,以随机数表法为依据分为两组,每组30例.对照组行单纯全麻处理,观察组行全麻复合TPVB处理,比较两组术中镇痛药用量、手术前后的机体应激指标、术后不同时点的疼痛程度以及术后恢复相关指标.结果 观察组术中瑞芬太尼用量(1.82±0.42)mg少于对照组(3.52±1.01)mg(t=7.010,P＜0.001).术后3d,观察组的血清去甲肾上腺素(Norepinephrine,NE)、皮质醇(Cortisol,Cor)及血清P物质(Serum substance P,SP)检测值均低于对照组(t=2.966,P=0.004;t=3.017,P=0.003;t=2.695,P=0.009).观察组术后2h、6h及 12h的数字疼痛评估量表(Digital Pain Assessment Scale,NRS)得分均低于对照组(t=4.047,P＜0.001;t=3.517,P＜0.001;t=2.132,P=0.037).观察组术后各恢复指标(拔管、首次下床活动及住院)时间均短于对照组(t=6.056,P＜0.001;t=4.840,P＜0.001;t=2.387,P=0.020).结论 全麻复合TPVB能够减少胸腔镜手术患者的术中镇痛药用量,减轻机体应激反应,减轻术后疼痛程度,加快患者术后恢复.
Abstract
Objective To investigate the analgesic effect of general anesthesia combined with thoracic paravertebral nerve block(TPVB)and intraoperative analgesic dosage on patients undergoing thoracoscopic surgery.Methods 60 patients who underwent thoracoscopic surgery in our hospital from February to October 2022 were selected and divided into two groups according to the random number table method,with 30 cases in each group.The control group was treated with general anesthesia alone,and the observation group was treated with general anesthesia combined with TPVB.The intraoperative analgesic dosage,body stress indicators before and after surgery,pain degree at different time points after surgery,and postoperative recovery related indicators were compared between the two groups.Results The intraoperative remifentanil dosage in the observation group was(1.82±0.42)mg less than(3.52±1.01)Mg in the control group(t=7.010,P＜0.001).Three days after operation,the detection values of serum norepinephrine(NE),cortisol(COR),and serum substance P(SP)in the observation group were lower than those in the control group(t=2.966,P=0.004;t=3.017,P=0.003;t=2.695,P=0.009).The scores of digital pain assessment scale(NRS)in the observation group at 2h,6h and 12h after operation were lower than those in the control group(t=4.047,P＜0.001;t=3.517,P＜0.001;t=2.132,P=0.037).The postoperative recovery index(extubation,first ambulation,and hospitalization)time of the observation group was shorter than that of the control group(t=6.056,P＜0.001;t=4.840,P＜0.001;t=2.387,P=0.020).Conclusion General anesthesia combined with TPVB can reduce the amount of intraoperative analgesics,reduce the body stress reaction,reduce the degree of postoperative pain,and accelerate the postoperative recovery of patients with thoracoscopic surgery.
关键词
麻醉/胸椎/镇痛Key words
anesthesia/thoracic vertebrae/analgesia引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据