罗哌卡因肋间神经阻滞对肺癌患者胸腔镜术后镇痛效果的影响

Effects of ropivacaine as intercostal nerve blocker on postoperative pain after video-assisted thoracic surgery of lung cancer patients

目的:探讨罗哌卡因肋间神经阻滞对肺癌患者胸腔镜术后镇痛效果的影响。方法:分析2016年10月至2016年12月天津医科大学肿瘤医院60例接受肺癌胸腔镜手术治疗的患者,男性35例,女性25例,随机分为2组,分别为0.25%罗哌卡因阻滞组(试验组)和对照组,关胸前行肋间神经阻滞,每一肋间给药3 mL,拔出气管插管后行PCIA镇痛。记录拔管后12 h(T1)、24 h(T2)、48 h(T3)、72 h(T4)时试验组及对照组静息时疼痛VAS评分及Prince-Henry(P-H)评分;以及术后吗啡追加剂量和不良反应事件。结果:试验组术后T1~T4各时间点VAS和P-H评分均低于对照组(P<0.01)。术后试验组咳嗽费力、肺部感染、肺不张等呼吸系统并发症发生率较低(P<0.05)。结论:罗哌卡因肋间神经阻滞可有效减轻肺癌术后患者疼痛并降低术后呼吸系统并发症。

Objective：To investigate the effects of ropivacaine as intercostal nerve blocker on postoperative pain after video-assisted thoracic surgery （VATS） of lung were cancer patients. Methods：A total of 60 patients who underwent elective VATS were randomly di-vided into two groups. The patients in control group were ereated with intercostal nerve blocker with saline. The patients in test group were administrated with intercostal nerve blocker with 0.25%ropivacaine. The effects were evaluated using the visual analogue scale （VAS） and Prince Henry Pain Scale （PHPS） at 12 （T1）, 24 （T2）, 48 （T3）, and 72 h （T4） after extubation. Moreover, the adverse events and dosage of morphine after surgery were measured. Results：Compared with the control group, the VAS and PHPS scores of the test group were significantly low at T1-T4 （P〈0.01）. Postoperative respiratory complications, such as pulmonary infection and atelectasis, were less in the test group （P〈0.05） than control. Conclusion：Intercostal nerve block with ropivacaine provides good analgesic effects for patients underwent VATS.