胸椎旁神经阻滞联合双腔支气管插管全身麻醉在胸腔镜肺大疱切除术患者中的应用效果

Application effects of thoracic paravertebral nerve block combined with double-lumen bronchial intubation general anesthesia in patients undergoing thoracoscopic pulmonary bulla resection

目的:观察胸椎旁神经阻滞联合双腔支气管插管全身麻醉在胸腔镜肺大疱切除术患者中的应用效果。方法:选取92例行胸腔镜肺大疱切除术的患者为研究对象,依据随机数字表法将其分为对照组与观察组各46例。对照组采用双腔支气管插管全身麻醉,观察组采用胸椎旁神经阻滞联合双腔支气管插管全身麻醉,比较两组麻醉效果、围术期血流动力学指标水平、术后视觉模拟评分法(VAS)评分及不良反应发生率。结果:观察组麻醉优良率为97.83%(45/46),明显高于对照组的82.61%(38/46),差异有统计学意义(P<0.05);T_(1)、T_(2)、T_(3)时,两组平均动脉压与心率均高于T_(0)时,但观察组低于对照组,差异有统计学意义(P<0.05);术后3、6、12 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:胸椎旁神经阻滞联合双腔支气管插管全身麻醉应用于胸腔镜肺大疱切除术患者可提高麻醉优良率,降低血流动力学指标水平、VAS评分和不良反应发生率,其效果优于双腔支气管插管全身麻醉。

Objective:To observe application effects of thoracic paravertebral nerve block combined with double-lumen bronchial intubation general anesthesia in patients undergoing thoracoscopic pulmonary bulla resection.Methods:92 patients who underwent thoracoscopic pulmonary bulla resection were selected as the research objects,and were divided into control group and observation group according to the random number table method,46 cases in each group.The control group received double-lumen bronchial intubation general anesthesia,while the observation group received thoracic paravertebral nerve block combined with double-lumen bronchial intubation general anesthesia.The anesthesia effects,the perioperative hemodynamic index levels,the visual analogue scale(VAS)score and the incidence of adverse reactions were compared between the two groups.Results:The excellent and good rate of anesthesia in the observation group was 97.83%(45/46),which was significantly higher than 82.61%(38/46)in the control group,and the difference was statistically significant(P<0.05).At T_(1),T_(2),and T_(3),the mean arterial pressure and heart rate levels in the two groups were higher than those at T_(0);those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).3,6,and 12 h after the surgery,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Thoracic paravertebral nerve block combined with double-lumen bronchial intubation general anesthesia in the patients undergoing thoracoscopic pulmonary bulla resection can improve the excellent and good rate of anesthesia,and reduce the levels of hemodynamic indexes,the VAS score and the incidence of adverse reactions.Moreover,it is superior to single double lumen bronchial intubation general anesthesia.