超声引导右美托咪定联合罗哌卡因胸椎旁神经阻滞对开胸手术患者的麻醉及术后镇痛效果的影响分析

Analysis of the Effect of Ultrasound-guided Dexmedetomidine Combined with Ropivacaine Thoracic Paravertebral Nerve Block on Anesthesia and Postoperative Analgesia in Patients Undergoing Thoracotomy

目的结合临床手术麻醉需求,就开胸手术患者麻醉中实施超声引导右美托咪定结合罗哌卡因实施胸椎旁神经阻滞的效果及术后镇痛影响分析。方法选取该院2020年10—12月收治的电视胸腔镜下肺癌手术男性患者60例为研究对象,根据随机数法分为3组,胸椎旁神经阻滞复合器官内插管全麻组(PG组)、硬膜外阻滞复合气管内插管全麻组(EG组)、全麻组(GA组),每组20例,实施不同麻醉方式,对比患者最终麻醉效果。结果3组患者HR及MAP生命体征对比中,PG组与GA组相比,差异有统计学意义(P<0.05),EG组与GA组相比,差异有统计学意义(P<0.05);3组患者手术时间、术中出血量、输液量、麻醉用药及48 h PCA自控给药次数对比差异有所不同,其中PG组与EG组除手术时间对比差异无统计学意义(P>0.05),其余4项对比,差异有统计学意义(P<0.05),EG组与GA组相比差异有统计学意义(P<0.05);3组患者术后12 h与24 hVAS评分对比,差异有统计学意义(P<0.05);患者术后不良反应发生率PG组10.00%与GA组30.00%比较,差异有统计学意义(P<0.05);患者术后QoR-40评分GA组优于EG组和PG组,EG组优于PG组,差异有统计学意义(P<0.05)。结论电视胸腔镜下肺癌手术患者给予胸椎旁神经阻滞复合器官内插管全麻效果显著,可满足患者麻醉需求。

Objective According to the needs of clinical surgical anesthesia,to analyze the effect of ultrasound-guided dexmedetomidine combined with ropivacaine in thoracic paravertebral nerve block and postoperative analgesia in patients undergoing thoracotomy.Methods A total of 60 male patients with lung cancer surgery under video-assisted thoracoscopy admitted to the hospital from October to December 2020 were selected as the research objects.They were divided into three groups according to the random number method.Anesthesia group(PG group),epidural block combined endotracheal intubation general anesthesia group(EG group),general anesthesia group(GA group),20 cases in each group,implemented different anesthesia methods,and compared the final anesthesia effect of the patients.Results In the comparison of HR and MAP vital signs of the three groups of patients,the PG group was statistically significant difference from the GA group(P<0.05),and the EG group was statistically significant difference from the GA group(P<0.05);the three groups of patients had statistically significant difference in operation time,intraoperative blood loss,infusion volume,anesthesia medication and 48 h PCA self-controlled administration frequency.Among them,there was no statistically significant difference in the operation time between the PG group and the EG group.The other four comparisons the difference was statistically significant(P<0.05),comparisons between EG group and GA group,the difference was statistically significant(P<0.05);the VAS score between the three groups of patients at 12 h and 24 h after operation,the difference was statistically significant(P<0.05);the incidence of adverse reactions after surgery 10.00% in the PG group and 30.00% in the GA group,the difference was statistically significant(P<0.05);the postoperative QoR-40 score of the GA group was better than that of the EG group and the PG group,and the EG group was better than the PG group,the difference was statistically significant(P<0.05).Conclusion The effect of general anesthesia with thoracic paravertebral nerve block complex organ intubation for lung cancer surgery patients under video-assisted thoracoscopic surgery is significant,which can meet the anesthesia needs of patients.