老年患者开胸手术采用椎旁神经阻滞术后镇痛的有效性、安全性及康复价值

Efficacy Safety and Rehabilitation Value of Paravertebral Nerve Block for Postoperative Analgesia in Elderly Patients Undergoing Thoracotomy

目的:对老年患者开胸手术采用椎旁神经阻滞术后镇痛的有效性、安全性及康复价值进行探讨。方法:选取笔者所在医院2016年9月-2017年9月收治的92例老年开胸手术患者进行分析,随机分为两组,每组46例。患者观察组给予超声引导下连续椎旁神经阻滞方案,对照组给予全身麻醉。结果:观察组术后不同时间的视觉模拟评分(VAS)均低于对照组(P<0.05)。观察组术后镇痛期间的不良反应发生率低于对照组(P<0.05)。此外,观察组术后IL-6、TNF-α、IL-10等炎性介质水平均优于对照组(P<0.05)。结论:临床对老年开胸手术患者实施超声引导下连续椎旁神经阻滞麻醉方案,可有效提升术后镇痛效果,减轻镇痛期间的不良反应,且对加快炎症消退、促进患者康复也有积极的影响。

Objective：To explore the efficacy,safety and rehabilitation value of paravertebral nerve block in elderly patients undergoing thoracotomy.Method：A total of 92 elderly patients with thoracotomy from September 2016 to September 2017 were selected and randomly divided into two groups,46 patients in each group.The patients in observation group were given the continuous paravertebral nerve block under ultrasound guidance,and the general anesthesia was given in the control group.Result：The scores of visual analogue scale（VAS） of different times in the observation group were lower than those in the control group（P〈0.05）.The incidence of adverse reactions during the postoperative analgesia in the observation group was lower than that in the control group（P〈0.05）.In addition,the levels of inflammatory mediators such as IL-6,TNF-α,IL-10 after surgery in the observation group were better than those in the control group.Conclusion：The continuous paraspinal nerve block anesthesia under ultrasound guidance in the elderly patients with thoracotomy can effectively improve the postoperative analgesic effect,reduce the adverse reaction during analgesia,and also have positive effects on accelerating the decline of inflammation and promoting the rehabilitation of the patients.