全身麻醉复合椎旁阻滞技术对贲门癌根治术患者术后恢复的影响

Impact of General Anesthesia Combined with Paravertebral Block Technology on Postoperative Recovery of General Thoracic Surgery

目的探究全身麻醉复合椎旁阻滞技术对普胸手术患者术后恢复的影响。方法选择2012年6月至2014年9月湖北省恩施土家族苗族自治州中心医院收治的68例接受贲门癌根治术治疗的患者为研究对象,按照随机数字表法分为对照组和试验组,各34例。对照组基于全身麻醉后行手术治疗;试验组基于全身麻醉复合椎旁阻滞下接受贲门癌根治术。对比两组患者的基本情况,术中麻醉用药状况及术后恢复情况。结果试验组术中七氟烷控制浓度、术中追加舒芬太尼量、24 h内舒芬太尼追加量、呼吸机支持时间均低于对照组[(1.40±0.11)%比(2.12±0.11)%,(5.02±1.01)μg比(26.01±4.03)μg,(0.10±0.01)mg比(0.41±0.10)mg,(45±15)min比(100±20)min],差异有统计学意义(P<0.01)。随着两组患者手术拔管后逐渐清醒,视觉模拟评分(VAS)呈上升趋势,试验组各时点VSA评分低于对照组,两组间、不同时点间、组间和不同时点间的交互作用比较差异有统计学意义(P<0.05)。结论全身麻醉复合椎旁阻滞技术对普胸手术患者术后恢复具有十分重要的影响,临床上应引起足够重视。

Objective To explore the impact of general anesthesia combined with paravertebral block technique on postoperative recovery of general thoracic surgery. Methods Total of 68 patients receiving gastric cardia cancer resection admitted to Enshi Central Hospital of Hubei Province from Jun. 2012 to Sep. 2014 were randomly divided into a control group and a test group,34 cases each. on the control group received general anesthesia then underwent surgery;the test group received paravertebral block under general anesthesia then underwent surgery. The basic situation, anesthetic drugs and postoperative recovery situation of the two groups of patients were compared. Results Sevoflurane concentration, the amount of intraoperative added fentanyl, 24 h fentanyl added amount, ventilator stupport time of the test group were less than the control group [ （1.40 ±0. 11）% vs （2. 12 ±0. 11）% ,（5.02± 1.01） μg vs （26.01±4. 03） μg, （0. 10 ± 0.01 ） mg vs （0. 41 ± 0. 10） mg, （45 ± 15 ） min vs （100 ± 20） mini ,the differences were statistically significant （ P 〈 0.05 ） .＇The visual analogue scale （VAS） of both groups showed an upward trend after extubation and regaining consciousness of the patients, the VSA scores of the test group at each time pointwere lower than the control group, the differences betweengroups, between different time points, and the interaction of the two groups at different time points were statistically significant （ P 〈 0.05 ）. Conclusion Paravertebral block combined with general anesthesia has great impact on the postoperative recovery of general thoracic surgery patients, and due attention should be paid in clinical.