口服药物镇痛在胸腔镜肺楔形术后镇痛中的应用研究

Application of Oral Analgesia in Postoperative Analgesia after Thoracoscopic Pulmonary Wedge Surgery

目的:探讨胸椎旁神经阻滞联合口服镇痛药物在单孔胸腔镜肺楔形术后镇痛中的应用效果。方法:将96例行单孔胸腔镜下肺楔形切除术患者按入院编号随机分为A组(胸椎旁神经阻滞联合口服曲马多)和B组(舒芬太尼静脉自控镇痛泵)各48例。比较2组术后48h内不同时间点的静息和咳嗽VAS疼痛评分、不良反应发生率及镇痛费用。结果:2组患者术后48h内静息和咳嗽时VAS评分比较及术后不良反应发生率比较,差异无统计意义(P>0.05);但A组术后镇痛总体费用显著低于B组(P<0.05)。结论:胸椎旁神经阻滞联合术后口服曲马多非静脉镇痛模式在单孔胸腔镜肺楔形切除术后镇痛效果良好,且经济实用、操作简单,不良反应较少。

[Objective]To investigate the effect of thoracic paravertebral nerve block combined with oral analgesics on analgesia after single-hole thoracoscopic pulmonary wedge surgery.[Method]96 patients undergoing single-hole thoracoscopic wedge resection of lung were randomly divided into group A(Thoracic paravertebral nerve block combined with oral tramadol,n=48)and group B(sufentanil intravenous controlled analgesia pump,n=48).VAS pain score,incidence of adverse reactions and cost of analgesia were compared between two groups at different time points within 48 hours after operation.[Result]There was no statistical difference in VAS score between the two groups at rest and cough within 48 hours after operation;there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05);but the cost of analgesia in group A was significantly lower than that in group B(P<0.05).[Conclusion]Parathoracic nerve block combined with oral tramadol non-venous analgesia after single-port thoracoscopic wedge lung resection has good analgesic effect,and is economical,practical,simple and less adverse reactions.