胸椎旁神经阻滞复合全身麻醉对肺癌根治术患者苏醒质量及疼痛程度的影响

Effect of thoracic paravertebral nerve block combined with general anesthesia on the quality of recovery and pain level in patients undergoing radical lung cancer surgery

目的探讨胸椎旁神经阻滞复合全身麻醉对肺癌根治术患者苏醒质量及疼痛程度的影响。方法根据麻醉方法的不同将100例肺癌根治术患者分为对照组和观察组,每组50例,对照组患者给予全身麻醉,观察组患者给予胸椎旁神经阻滞复合全身麻醉。记录观察组患者的穿刺成功率,比较两组患者的躁动情况、苏醒质量、疼痛程度[视觉模拟评分法(VAS)]、应激反应指标[去甲肾上腺素(NE)、肾上腺素]和并发症发生情况。结果观察组患者的穿刺成功率为100%。观察组患者的苏醒时间、自主呼吸恢复时间均明显短于对照组,差异均有统计学意义(P<0.01)。对照组患者的躁动发生率为16.00%,高于观察组患者的4.00%,差异有统计学意义(P<0.05)。术后2、6、12、24 h,两组患者的VAS评分均低于本组术前,且观察组患者的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。拔管10 min后(T_(4)),观察组患者NE、肾上腺素水平均明显低于对照组,差异均有统计学意义(P<0.01)。对照组患者并发症总发生率为14.00%,与观察组患者的8.00%比较,差异无统计学意义(P>0.05)。结论胸椎旁神经阻滞复合全身麻醉能够迅速缓解肺癌根治术患者的疼痛程度,降低应激反应和躁动发生率,有助于患者术后快速苏醒,并提高苏醒质量。

Objective To explore the effect of thoracic paravertebral nerve block combined with general anesthesia on the quality of recovery and pain level in patients undergoing radical lung cancer surgery.Method A total of 100 radical lung cancer surgery patients were divided into control group(n=50,received general anesthesia)and observation group(n=50,received thoracic paravertebral nerve block+general anesthesia)according to different anesthesia methods.Record the success rate of puncture in the observation group,and compare the restlessness,awakening quality,pain level[visual analogue scale(VAS)],stress response indicators[norepinephrine(NE),adrenaline],and complications between the two groups.Result The success rate of puncture in the observation group was 100%.The recovery time and spontaneous breathing recovery time of the observation group were significantly shorter than those of the control group,and the differences were statistically significant(P<0.01).The incidence of restlessness in the control group was 16.00%,higher than 4.00%in the observation group,and the difference was statistically significant(P<0.05).At 2,6,12,and 24 hours after surgery,the VAS scores of both groups were lower than those before the surgery,and the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 10 minutes of extubation(T_(4)),the levels of NE and adrenaline in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).The total incidence of complications in the control group was 14.00%,compared with 8.00%in the observation group,the difference was not statistically significant(P>0.05).Conclusion Thoracic paravertebral nerve block combined with general anesthesia can quickly alleviate the pain level of lung cancer patients undergoing radical surgery,reduce the incidence of stress reactions and restlessness,help patients quickly recover after surgery,and improve the quality of recovery.