摘要
目的探讨超声下前锯肌平面阻滞在胸腔镜肺大泡手术中的应用。方法选择2019年11月~2020年5月大连市中心医院实施择期胸腔镜下肺大泡切除术患者80例为研究对象。按照随机数字表法分为对照组与观察组,各40例。对照组采用胸椎旁神经阻滞,观察组采用超声引导下前锯肌阻滞。比较两组麻醉苏醒过程中疼痛数字评分(NRS)、主观舒适度评分;比较两组术后48 h内单次追加阿片类镇痛药物次数;比较两组麻醉苏醒后6 h疼痛介质人P物质(SP)和神经肽Y(NPY)水平。结果麻醉苏醒后2、6、12 h,观察组NRS评分均低于对照组,差异有统计学意义(P<0.05);麻醉苏醒后2、6、12 h,观察组主观舒适度评分均高于对照组,差异有统计学意义(P<0.05);观察组术后48 h内单次追加阿片类镇痛药物次数少于对照组,差异有统计学意义(P<0.05);麻醉苏醒后6 h,观察组SP和NPY水平均低于对照组,差异有统计学意义(P<0.05)。结论针对胸腔镜手术,应用胸椎旁阻滞镇痛,能有效的缓解患者术后疼痛,提高舒适度,减少阿片类镇痛药物使用剂量。
Objective To investigate application of serratus anterior plane block under ultrasound in thoracoscopic pulmonary bullae surgery.Methods A total of 80 patients undergoing thoracoscopic bullae surgery in Dalian Municipal Central Hospital from November 2019 to May 2020 were selected as the research subjects.According to the random number table method,they were divided into the control group and the observation group,with 40 cases in each group.In the control group,thoracic paravertebral nerve block was used,and in the observation group,ultrasound-guided serratus anterior block was adopted.The changes in pain numeric rating scale(NRS)scores during the recovery from anesthesia between the two groups were compared.The subjective comfort scores during the recovery from anesthesia between the two groups were compared.The condition of opioid adding once within 48 h after surgery was compared.The levels of pain mediators including substance P(SP)and nerve peptide Y(NPY)were compared between the two groups at 6 h after awakening from anesthesia.Results The pain NRS scores of the observation group at 2,6,12 h after awakening from anesthesia were lower than those of the control group,the differences were statistically significant(P<0.05).The subjective comfort scores at 2,6,12 h after awakening from anesthesia in the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).The frequency of adding opioid analgesics once in the observation group at 48 h after operation was less than that in the control group,the difference was statistically significant(P<0.05).6 h after awakening from anesthesia,the levels of SP and NPY were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion For thoracoscopic surgery,the application of serratus anterior plane block under ultrasound can effectively alleviate patient′s postoperative pain,improve comfort,and reduce the dosage of opioid analgesics.
作者
邹佳芮
康鸿哲
霍晓蓓
ZOU Jia-rui;KANG Hong-zhe;HUO Xiao-bei(Department of Anesthesiology,Dalian Municipal Central Hospital,Liaoning Province,Dalian116000,China)
出处
《中国当代医药》
2021年第2期123-125,129,共4页
China Modern Medicine
关键词
前锯肌平面阻滞
超声下
胸腔镜
肺大泡
Serratus anterior plane block
Under ultrasound
Thoracoscope
Pulmonary bullae
