超声引导胸椎旁神经阻滞在开胸手术中的应用效果观察

Effect Observation of Ultrasound-guided Paravertebral Nerve Block in Application of Patients Undergoing Thoracotomy

目的探讨超声引导胸椎旁神经阻滞对开胸手术的镇痛效果及其对血流动力学和应激反应的影响。方法选择2012年3月—2016年2月收治的开胸手术患者80例,按麻醉方法分为观察组和对照组,每组40例。观察组给予超声引导下胸椎旁神经阻滞麻醉,对照组给予全身麻醉。比较2组术后镇痛效果、血流动力学及应激反应指标水平。结果观察组休息时和咳嗽时术后2、6、12、48 h视觉模拟疼痛评分均低于对照组(P<0.05)。2组麻醉后血流动力学和应激反应指标组内和组间比较差异均有统计学意义(P<0.05)。结论对开胸手术患者应用超声引导下胸椎旁神经阻滞镇痛效果较好,血流动力学较稳定,可抑制术中及术后应激反应,有利于术后康复。

Objective To investigate effect of ultrasound-guided paravertebral nerve block on analgesia, hemodynamics and stress reaction in patients undergoing thoracotomy. Methods A total of 80 patients undergoing thoracoto- my admitted during March 2012 and February were divided into observation group （n = 40） and control group （n = 40） according to anesthetic method. Observation group was given ultrasound-guided paravertebral nerve block for analgesia, while control group received general anesthesia. Effects of postoperative analgesia, hemodynamics and stress reaction lev- els were compared in two groups. Results In observation group, visual analogue pain scores at postoperative 2^nd , 6^th , 12^th and 48^th h both resting and coughing were significantly lower than those in control group （P 〈0. 05）. There were sig- nificant differences in hemodynamics and stress reaction within the group and between the two groups （ P 〈 0.05）. Con- clusion Ultrasound-guided thoracic paravertebral nerve block has the good analgesia effect for patients undergoing thora- cotomy, and it can also achieve stable hemodynamics and inhibit intraoperative and postoperative stress reaction, which is beneficial to postoperative rehabilitation.