肋间神经阻滞在小儿心脏术中应用的疗效分析

Analysis about effectof intercostal nerve block in pediatric cardiac surgery

目的分析罗哌卡因肋间神经阻滞对小儿房间隔缺损经胸封堵术镇静、镇痛效果及并发症的影响。方法选取2018年10月-2020年8月间本院收治择期行房间隔缺损经胸封堵术儿童117例,随机分为观察组和对照组。比较两组患者术后FLACC评分、CRIES评分及术后苏醒拔管期Riker镇静躁动评分,ICU滞留时间、气管插管拔除时间、术后住院时间、术后疼痛缓解时间和术后不良反应发生情况。结果肋间神经阻滞后,观察组患者术后疼痛评分均低于对照组,差异有统计学意义(均P<0.05)。ICU滞留时间、气管插管拔除时间、术后住院时间观察组明显少于对照组,差异有统计学意义(均P<0.05)。观察组患者疼痛缓解时间较对照组短,差异有统计学意义(P<0.05)。观察组并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论房间隔缺损经胸微创封堵患者术中行肋间神经阻滞,不良反应小、镇痛效果确切、安全性较高,操作简便,具有较好的临床应用推广价值。

Objective To analyze the effects of ropivacaine intercostal nerve block on sedation,analgesia,and complications after transthoracic closure of Atrial Septal Defect(ASD)in children.Methods From October 2018 to August 2020,117 children with ASD underwent selective transthoracic closure in our hospital and were randomly divided into observation groups and control group.Postoperative FLACC,CRIES,Riker sedation agitation scores,ICU stay,tracheal intubation,extubation time,hospital stay,pain relief time,and occurrence of postoperative adverse reactions were analyzed.Results Postoperative pain scores of the observation group were significantly lower than those of the control group after intercostal nerve block(P<0.05).ICU stay time,postoperative hospital stay and tracheal intubation removal time in the observation groupwere significantly shorter than those in the control group,and those differences were statistically significant(P<0.05).Pain relief time of the observation groupwas shorter than that of control group,and the difference was statistically significant(P<0.05).In the observation group,complications were significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Intercostal nerve block method can be used intraoperatively during minimally invasive thoracic closure of ASD in patients with relatively few adverse reactions.Analgesic effect is more precise,safety is higher,and it is easy to operate.So ithas good clinical application and is worthy of promotion.