摘要
目的探讨超声引导下肋间神经阻滞对乳腺癌术后患者的影响。方法选取2016年10月~2019年9月我院收治的50例乳腺癌手术患者作为研究对象,依据随机数字表法将患者分为观察组和对照组,每组各25例。两组患者均在全身麻醉下进行乳腺癌根治术,观察组患者选择超声引导下肋间神经阻滞的方式实现术后镇痛,对照组患者选择静脉自控镇痛(PCIA)的方式实现术后镇痛。手术完成后,记录两组患者的拔除气管导管时间、自主呼吸时间以及完全清醒时间,比较两组患者术后2、4、8、12、24 h的镇痛、镇静评分。结果观察组患者的拔除气管导管时间、自主呼吸时间以及完全清醒时间均短于对照组,差异有统计学意义(P<0.05);观察组患者术后2、4 h的视觉模拟量表(VAS)评分低于对照组,差异有统计学意义(P<0.05);两组患者术后8、12和24 h的VAS评分比较,差异无统计学意义(P>0.05);观察组患者术后不同时间段(术后2、4、8、12、24 h)的镇静评分均低于对照组,差异有统计学意义(P<0.05)。结论超声引导下肋间神经阻滞能够缩短拔除气管导管时间、自主呼吸时间以及完全清醒时间,可以发挥较好的镇静、镇痛作用。
Objective To explore the influence of ultrasound-guided intercostal nerve block on patients with postoperative breast cancer.Methods From October 2016 to September 2019,50 cases of breast cancer surgery patients in our hospital were selected as the subjects.According to the random number table method,the patients were divided into the observation group and the control group,25 cases in each group.The patients in both groups underwent radical mastectomy under general anesthesia.The observation group used ultrasound-guided intercostal nerve block to achieve postoperative analgesia,while the control group used patient-controlled intravenous analgesia(PCIA)to achieve postoperative analgesia.After the operation,the time of tracheal extubation,the time of spontaneous respiration and the time of complete awake of the two groups were recorded,and the scores of analgesia and sedation at 2,4,8,12,24 h after surgery were compared between the two groups.Results The time of tracheal extubation,the time of spontaneous respiration and the time of complete awake in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the observation group 2 and 4 h after surgery were lower than those of the control group,and the differences were statistically significant(P<0.05).VAS scores at 8,12 and 24 h after surgery showed no significant difference between the two groups(P>0.05).The sedation scores of the observation group at different postoperative periods(2,4,8,12 and 24 h after surgery)were all lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided intercostal nerve block can shorten the time of tracheal extubation,the time of spontaneous respiration and the time of complete awake,and play a better role in sedation and analgesia.
作者
盛雪
黄霖彦
梁海舟
王伟
SHENG Xue;HUANG Lin-yan;LIANG Hai-zhou;WANG Wei(Department of Anesthesiology,Huiya Hospital of the Affiliated to Hospital,Sun Yat-sen University in Huizhou City,Guangdong Province,Huizhou 516081,China)
出处
《中国当代医药》
2020年第16期161-164,共4页
China Modern Medicine
基金
广东省惠州市医疗卫生类科技计划项目(2019Y368)。
关键词
乳腺肿瘤
麻醉和镇痛
超声检查
肋间神经
Breast tumor
Anesthesia and analgesia
Ultrasonic examination
Intercostals nerve
