超声引导罗哌卡因胸椎旁神经阻滞对56例开胸手术患者早期应激反应的影响

Effect of ultrasound-guided ropivacaine paravertebral nerve block on early stress response in 56 cases of patients undergoing thoracic surgery

目的 :探讨超声引导罗哌卡因胸椎旁神经阻滞对开胸手术患者早期应激反应的影响。方法 :选取开胸手术患者112例随机分为对照组与观察组各56例,对照组给予单纯全身麻醉,观察组给予超声引导罗哌卡因胸椎旁神经阻滞复合全身麻醉。比较两组各时间段C反应蛋白(C-reaction protein,CRP)、皮质醇(cortisol,COR)、丙二醛(malonaldehyde,MDA)等应激反应指标、循环波动及术中用药情况。结果 :两组手术开始2h(T_1)、手术结束(T_2)、术后24h(T_3)CRP、COR水平高于气管插管时(T_0),T_2、T_3时MDA高于T_0时(P<0.05);观察组T_2、T_3时CRP、COR、MDA水平低于对照组(P<0.05);观察组循环波动及术中用药情况均优于对照组。结论 :超声引导罗哌卡因胸椎旁神经阻滞复合全身麻醉用于开胸手术患者有利于减轻早期应激反应。

Objective： To study the efect of ultrasound-guided ropivacaine paravertebral nerve block on early stress response in patients undergoing thoracotomy. Methods： One hundred and twelve patients undergoing thoracotomy were randomly divided into a control group and an experimental group with 56 cases each. The control group was given simple general anesthesia, while the experimental group was treated with ultrasound-guided ropivacaine paravertebral nerve block combined with general anesthesia. Stress response indexes, such as C-reactive protein （CRP）, cortisol （COR）, malondialdehyde （MDA） and so on, circulation fuctuation and intraoperative drug use were compared between the two groups. Results： CRP and COR levels at 2 h （T1） after operation, the end of operation （T2） and postoperative 24 h （T3） in the two groups were higher than those at tracheal intubation （T0） and MDA levels at T2 and T3 were higher than those at T0 （P〈0.05）. CRP, COR and MDA levels at T2 and T3 were lower in the experimental group than the control group. The circulation fuctuation and the drug use in the operation were much better in the experimental group than the control group （P〈0.05）. Conclusion： Ultrasound-guided ropivacaine thoracic paravertebral nerve block combined with general anesthesia for thoracotomy is of beneft to relieving early stress response.