全麻复合超声引导下的单次胸椎旁神经阻滞在胸科手术术中及术后镇痛效果分析

Analgesic Effect of Single Thoracic Paravertebral Nerve Block Guided by General Anesthesia Combined with Ultrasound during and after Thoracic Surgery

目的评估全麻复合超声引导下的单次胸椎旁神经阻滞应用于胸科手术患者对其术中与术后的镇痛效果。方法该文临床资料为该医院收入拟行胸科手术治疗的70例患者,选取时间2016年4月—2018年8月,依据随机数字表法予以分组,一组入组35例,试验组采用全麻复合超声引导下的单次胸椎旁神经阻滞,对照组采用静吸复合全身麻醉,评定两组术后2、6、12、24h视觉模拟疼痛评分值,计算两组术后并发症总统计率、术中瑞芬太尼应用剂量。结果试验组术后2、6、12、24h视觉模拟疼痛评分值相较对照组对应计算值显著减少(2.78±0.50)分、(2.59±0.60)分、(2.98±0.70)分、(2.30±0.41)分vs(4.20±1.23)分、(4.72±1.30)分、(4.95±1.40)分、(3.16±1.20)分(t=6.327、8.801、7.445、4.012,P<0.05),试验组术后并发症总统计率相较对照组对应计算值显著减少(2.86%vs17.14%)(χ^2=3.968,P<0.05),试验组术中瑞芬太尼应用剂量相较对照组对应计算值显著减少(1.89±0.40)mgvs(1.10±0.23)mg,差异有统计学意义(t=10.129,P<0.05)。结论对胸科手术患者实施全麻复合超声引导下的单次胸椎旁神经阻滞呈现良好术中和术后的镇痛效果,展示重要临床价值。

Objective To evaluate the analgesic effect of single thoracic paravertebral nerve block guided by general anesthesia combined with ultrasound in patients undergoing thoracic surgery. Methods The clinical data of this article were collected from 70 patients who were scheduled to undergo thoracic surgery in our hospital from April 2016 to August 2018. They were divided into two groups according to random number table method. Each group was consisted of 35 patients. The experimental group was treated with single thoracic paravertebral nerve block guided by general anesthesia combined with ultrasound. The control group was treated with intravenous inhalation combined with general anesthesia. The visual models of the two groups were evaluated at 2, 6, 12 and 24 h after operation. The total statistical rate of postoperative complications in the two groups, and the intraoperative dose of remifentanil were calculated. Results At 2, 6, 12 and 24h after surgery, the visual simulated pain score of the experimental group was significantly reduced, compared with the control group (2.78±0.50)points,(2.59±0.60)points,(2.98±0.70)points,(2.30±0.41)points vs (4.20±1.23)points,(4.72±1.30)points (4.95±1.40)points,(3.16±1.20)points(t=6.327, 8.801, 7.445, 4.012, P<0.05). The total statistical rate of postoperative complications in the experimental group was significantly lower than that in the control group (2.86% vs17.14%)(χ^2=3.968, P<0.05). The intraoperative dose of remifentanil in the experimental group was significantly lower than that in the control group (1.89±0.40)mg vs (1.10±0.23)mg(t=10.129, P<0.05), indicating statistical significance between the two groups. Conclusion Single thoracic paravertebral nerve block guided by general anesthesia combined with ultrasound has good analgesic effect during and after thoracic surgery, showing important clinical value.