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超声引导下单次竖脊肌平面阻滞对肝癌切除术患者静脉自控镇痛效果的影响

Effect of ultrasound-guided single erector spinae plane block on self-controlled intravenous analgesia in patients undergoing hepatectomy
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摘要 目的观察超声引导下竖脊肌平面阻滞在肝癌切除手术术后辅助镇痛的效果。方法 60例择期全麻下行经腹肝癌切除术患者,性别不限,年龄35~75岁,体重45~85 kg,ASAⅠ~Ⅱ级。随机分成全麻复合ESPB组(ESPB组)和单纯全麻组(C组)。ESPB组在全麻诱导前行ESPB。2组患者术后使用PCIA镇痛。记录患者术后2 h、4 h、6 h、12 h、24 h、36 h、48 h的静息和活动时VAS评分、PCIA按压次数、补救镇痛例数、首次下床活动时间、术后镇痛满意度和恶心呕吐情况。结果 ESPB阻滞范围不稳定,术后1~24 h ESPB组静息和活动时VAS评分低于C组(P<0.05),ESPB组镇痛泵1~24 h按压次数少于C组(P<0.05),ESPB组使用哌替啶补救镇痛少于C组(P<0.05),ESPB组首次下床活动所需时间短于C组(P<0.05)。ESPB组术后镇痛满意度高于C组(P<0.05)。2组术后恶心、呕吐发生率比较,差异无统计学意义。结论在肝癌切除术患者术后镇痛中,超声引导下单次ESPB联合PCIA较单纯PCIA有一定优势。 Objective To observe the clinical effect of ultrasound-guided erector spine plane block(ESPB)in assisting analgesia after liver cancer resection.Methods Sixty patients underwent transabdominal hepatectomy under general anesthesia,age 35-75 years old,weight 45-85 kg and ASA classⅠorⅡ.They were randomly divided into general anesthesia combined with ESPB group(ESPB group)and simple general anesthesia group(group C).ESPB group was performed before general anesthesia induction.PCIA analgesia was used for postoperative analgesia in both groups.The resting and active VAS scores at 2h,4h,6h,12h,24h,36h,and 48h after surgery,the number of analgesic pump presses,the number of meperidine remedies for analgesia,the time of the first ambulation,the satisfaction of postoperative analgesic effect and the occurrence of nausea and vomiting were recorded.Results ESPB block range was unstable.The VAS scores 1-24h in the ESPB group at rest and activity were lower than those in the C group(P<0.05).The number of compressions of the analgesic pump 1-24h in the ESPB group was lower than that in the C group(P<0.05).ESPB group used pethidine to relieve pain less than group C(P<0.05).The time needed to get out of bed for the first time in the ESPB group was shorter than that in the C group(P<0.05).The satisfaction of postoperative analgesia in ESPB group was higher than that of in the C group(P<0.05).There was no significant difference in the incidence of nausea and vomiting between the two groups.Conclusion Ultrasound-guided single ESPB combined with PCIA has certain advantages over PCIA alone in postoperative analgesia for patients undergoing hepatectomy.
作者 吴健 赵亮 WU Jian;ZHAO Liang(Department of Anesthesiology,No.960 Hospital of PLA,Zibo,Shandong 255300,China)
机构地区 解放军第
出处 《实用医药杂志》 2021年第7期592-595,共4页 Practical Journal of Medicine & Pharmacy
关键词 超声 竖脊肌平面阻滞 肝癌 镇痛 Ultrasound Erector spinae block Liver cancer Analgesia
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