超声引导下胸椎旁神经阻滞复合全身麻醉在乳腺癌根治术中的应用效果

Effect of Ultrasound-guided Thoracic Paravertebral Nerve Block Combined with General Anesthesia in Radical Mastectomy for Breast Cancer

目的:探讨超声引导下胸椎旁神经阻滞复合全身麻醉用于乳腺癌根治术中的效果。方法:选取2019年2月-2020年2月82例福建医科大学附属漳州市医院行乳腺癌根治术治疗的患者。以随机方式将其分为观察组和对照组,每组41例。对照组采取气管插管静吸复合全身麻醉,观察组采取超声引导下胸椎旁神经阻滞复合全身麻醉。比较术后2、4、8、12 h疼痛评分,不良反应,药物用量及静脉自控镇痛模式(PCIA)按压情况,血流动力学。结果:观察组术后2、4、8、12 h的视觉模拟评分(visual analogue scale,VAS)评分均低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。观察组术中舒芬太尼用量、丙泊酚用量及术后PCIA按压次数均少于对照组(P<0.05)。观察组平均动脉压、心率均低于对照组(P<0.05)。结论:超声引导下胸椎旁神经阻滞复合全身麻醉用于乳腺癌根治术,不仅能有效减轻患者术后机体疼痛,又能减少药物用量和PCIA操作次数,稳定其血流和心率,安全性更高。

Objective:To investigate the effect of ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia in radical mastectomy for breast cancer.Method:From February 2019 to February 2020,82 patients treated by radical breast cancer in Zhangzhou Hospital Affiliated to Fujian Medical University were selected.They were divided into observation and control groups in a random manner,with 41 cases in each group.The control group received compound general anesthesia with endotracheal intubation and static aspiration,and the observation group received ultrasound-guided thoracic paravertebral nerve block composite general anesthesia.Pain scores 2,4,8,24 h after surgery,adverse effects,drug dosage,and patient controlled intravenous analgesia(PCIA)compression,hemodynamics were compared.Result:The visual analogue scale(VAS)scores of the observation group at 2,4,8 and 12 hours after operation were lower than those of the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).The dosage of Sufentanil,Propofol and the number of PCIA compression in the observation group were less than those in the control group(P<0.05).The mean arterial pressure and heart rate in the observed group were lower than those in the control group(P<0.05).Conclusion:Ultrasound-guided thoracic paravertebral nerve block combined with general anesthesia in radical mastectomy for breast cancer can not only effectively reduce the postoperative body pain of patients,but also reduce the drug dosage and PCIA operation times,stabilize their blood flow and heart rate,with higher safety.