超声引导下肋间神经阻滞复合静脉镇痛用于肋骨骨折切开复位内固定手术术后镇痛

Intercostal nerve block guided by ultrasound combined with intravenous analgesia in patients with rib fractures undergoing open reduction and internal fixation

目的评价超声引导下肋间神经阻滞复合静脉镇痛在肋骨骨折切开复位内固定手术术后镇痛的效果与对呼吸的影响。方法肋骨骨折患者60例，随机分为静脉镇痛组和复合肋间神经阻滞组，每组30例。前者采取静脉镇痛泵进行术后镇痛；后者在静脉镇痛泵基础上，采用超声引导下肋间神经阻滞。观察两组患者术后低氧血症和高碳酸血症发生情况及镇痛效果。结果两组患者术后各时点镇痛效果差异无统计学意义（P〉O．05）；复合肋间神经组低氧血症和高碳酸血症发生率较静脉镇痛组低（P〈0．05）。结论超声引导下肋间神经阻滞复合静脉术后镇痛对呼吸的影响较小，镇痛效果满意，与静脉术后镇痛效果相当。

Objective To evaluate the analgesic efficacy and respiratory influence of intercostal nerve block guided by ultrasound combined with intravenous analgesia in patients undergoing open reduction and internal fixation for rib fractures. Methods Sixty patients with rib fractures were randomly divided into in- travenous analgesia group （intravenous analgesia pump for postoperative analgesia） and combined intercostal nerve group （ultrasound guided intercostal nerve block combined with intravenous analgesia pump）, 30 cases in each group. The analgesic efficacy, incidence of hypoxemia and hypercapnia in both groups were observed. Re- suits No difference was found in analgesic efficacy at each time point after the operation between two groups （P〉0.05）. The incidence of hypoxemia and hypercapnia was significantly lower in the combined intercostal nerve group than that in the intravenous analgesia group （P〈0.05）. Conclusion Respiratory influence of inter- costal nerve block guided by ultrasound combined with intravenous analgesia is lower than that of intravenous analgesia. The efficacy of its postoperative analgesia is effective and safe, which is similar to the intravenous postoperative analgesia.