超声引导下椎旁神经阻滞应用于老年人开胸手术术后镇痛效果

Ultrasound-guided Paravertebral Nerve Block for Postoperative Analgesia in Elderly Patients Undergoing Thoracotomy

目的探究老年开胸手术患者接受超声引导下椎旁神经阻滞术后镇痛的效果。方法以老年开胸手术患者48例为研究对象,所选时间为2017年8月—2018年8月,以计算机随机化法分组,随机分为对照组和实验组,每组24例患者,其中对照组实施全身麻醉,实验组则实施超声引导下椎旁神经阻滞干预,分析2组老年开胸手术患者镇痛的效果。结果实验组老年开胸手术患者术后2、12、24、48h的疼痛评分分别为(2.12±0.31)分、(3.03±0.15)分、(2.67±0.34)分、(1.31±0.37)分均低于对照组的(4.98±0.26)分、(5.15±0.20)分、(3.67±0.40)分、(3.11±0.36)分,差异有统计学意义(t=34.6296,41.5433,9.3318,17.0816,P<0.05);实验组的不良反应几率(12.50%)较对照组不良反应几率(37.50%)低(χ^2=4.000,P<0.05);老年开胸手术患者患者的MAP、HR稳定性实验组也明显优于对照组,差异有统计学意义(P<0.05)。结论老年开胸手术患者接受超声引导下椎旁神经阻滞干预,其术后镇痛效果较好,可将其镇痛期间的相关不良反应减轻,且可对手术中生命体征的稳定性维持。

Objective To investigate the effect of ultrasound-guided analgesia after paravertebral nerve block in elderly patients undergoing thoracotomy.Methods Forty-eight patients with open thoracotomy were enrolled in the study.The selected time was from August 2017 to August 2018.They were randomly divided into control group and experimental group,with 24 patients in each group.The control group underwent general anesthesia,and the experimental group underwent ultrasound-guided paravertebral nerve block intervention to analyze the analgesic effect of the two groups of elderly patients undergoing thoracotomy.Results The pain scores of the elderly patients undergoing thoracotomy at 2,12,24 and 48 h were(2.12±0.31)points,(3.03±0.15)points,(2.67±0.34)points and(1.31±0.37)points,respectively,which were lower than the(4.98±0.26)points and(5.15±0.20)points,(3.67±0.40)points,(3.11±0.36)points of the control group,the difference was statistically significant(t=34.629 6,41.543 3,9.331 8,17.081 6,P<0.05);the adverse reaction rate of the experimental group(12.50%)was lower than that of the control group(37.50%)(χ^2=4.000,P<0.05).The MAP and HR stability test group of elderly patients undergoing thoracotomy was also significantly better than the control group,and the difference was statistically significant(P<0.05).Conclusion Patients undergoing ultrasound-guided paravertebral nerve block intervention in elderly patients undergoing thoracotomy have better postoperative analgesia,which can alleviate the adverse reactions during analgesia and maintain the stability of vital signs during surgery.