超声引导下单次竖脊肌阻滞联合PCIA在肺叶切除术患者术后镇痛中的应用

Application of ultrasound-guided single erector spinae block combined wit h PCIA in postoperative analgesia in patients with lobectomy

目的:探究超声引导下单次竖脊肌阻滞联合PCIA在肺叶切除术患者术后镇痛中的应用效果。方法:选取肇庆市第一人民医院2020年3月至2021年3月期间收治的100例接受肺叶切除术治疗的患者为研究对象,根据随机数表法将所有患者分为对照组与观察组(50例/组)。在术后,对两组患者均进行PCIA。在麻醉诱导前,对观察组患者进行超声引导下单次竖脊肌阻滞。然后对比两组患者术后1 h、6 h、18 h、24 h、48 h静息状态下及咳嗽状态下的VAS评分、镇痛泵的按压次数、氟比洛芬酯的输注总量和不良反应的发生率。结果:观察组患者术后1 h、6 h、18 h、24 h、48 h静息状态下及咳嗽状态下的VAS评分均明显低于对照组患者,差异有统计学意义(P<0.05)。在术后24 h内、术后48 h内,观察组患者的镇痛泵按压次数、氟比洛芬酯输注总量均少于对照组患者,差异有统计学意义(P<0.05)。在术后,两组患者不良反应的发生率相比,差异无统计学意义(P>0.05)。结论:超声引导下单次竖脊肌阻滞联合PCIA在肺叶切除术患者术后镇痛中的应用效果较好,能有效缓解患者的疼痛症状,且安全性较高。

Objective:To explore the application effect of ultrasound-guided single erector spinae block combined with PCIA in postoperative analgesia in patients with lobectomy.Methods:A total of 100 patients treated with lobectomy in Zhaoqing First People’s Hospital from March 2020 to March 2021 were selected as the research objects.According to the random number table method,all patients were divided into the control group and the observation group(50 cases/group).After operation,PCIA was performed in both groups.Before anesthesia induction,single erector spinae block guided by ultrasound was performed in the observation group.Then the VAS score,pressure times of analgesic pump,total amount of flurbiprofen axel infusion and incidence of adverse reactions were compared between the two groups at 1 h,6 h,18 h,24 h and 48 h after operation.Results:The VAS scores of patients in the observation group at 1 h,6 h,18 h,24 h,48 h after operation in the resting state and cough state were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Within 24 h and 48 h after operation,The Times of analgesic pump pressing and the total amount of flurbiprofen axel infusion in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).After operation,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ultrasound-guided single erector spinae block combined with PCIA has a good effect on postoperative analgesia in patients with lobectomy,which can effectively relieve the pain symptoms of patients wit h high safety.