摘要
目的探讨超声引导下前锯肌平面阻滞麻醉用于胸腔镜手术中的效果及其对氧代谢的影响。方法选择2018年3月至2020年8月广东省人民医院珠海医院(珠海市金湾中心医院)麻醉科收治的80例接受胸腔镜手术患者为研究对象,根据麻醉方案不同分为观察组和对照组,每组各40例。观察组采用超声引导下前锯肌平面阻滞麻醉,对照组采用全凭静脉麻醉,对两组患者血流动力学指标、氧动力学指标、不良反应进行比较。结果两组T1-T3时段平均动脉压(MAP)、心率(HR)水平均与T0时相比,差异均有统计学意义(P<0.05),两组麻醉前(T0)的MAP、HR相比,差异无统计学意义(P>0.05),观察组切皮时(T1)、拔管前即刻(T2)、术后2 h(T3)的MAP、HR低于对照组,差异有统计学意义(P<0.05);两组T1-T3时段混合静脉血氧饱和度(SvO_(2))、氧耗(VO_(2))水平与T0时相比,差异均有统计学意义(P<0.05),两组T0时的SvO_(2)、VO_(2)比较,差异无统计学意义(P>0.05),观察组T1、T2、T3时间段的SvO_(2)低于对照组,VO_(2)高于对照组,差异有统计学意义(P<0.05);观察组苏醒期躁动、寒战发生率为2.50%、2.50%,低于对照组的15.00%、17.50%,差异有统计学意义(P<0.05)。结论超声引导下前锯肌平面阻滞麻醉用于胸腔镜手术中能维持血流动力学与氧代谢稳定、平衡,也能减少苏醒期躁动、寒战发生,值得推广。
Objective To investigate the effect of ultrasound-guided serratus anterior plane block anesthesia in thoracoscopic surgery and its influence on oxygen metabolism.Methods A total of 80 patients who underwent thoracoscopic surgery and admitted to the Department of Anesthesiology of the Guangdong Provincial People's Hospital Zhuhai Hospital(Zhuhai Golden Bay Center Hospital)from March 2018 to August 2020 were selected as the study objects.Grouped according to different anesthesia schemes,40 patients in the observation group received ultrasound-guided serratus anterior plane block anesthesia,while 40 patients in the control group received total intravenous anesthesia.The hemodynamic indexes,oxygen dynamics indexes,and adverse reactions were compared between the two groups.Results The mean arterial pressure(MAP)and heart rate(HR)of the two groups at T1-T3 were significantly different from those at T0(P<0.05).There were no statistically significant differences in MAP and HR between the two groups before anesthesia(T0)(P>0.05).The MAP and HR of the observation group at the time of skin incision(T1),immediately before extubation(T2)and 2 hours after operation(T3)were lower than those of the control group,with statistically significant differences(P<0.05).The SvO_(2) and VO_(2) levels of the two groups at T1-T3 were significantly different from those at T0(P<0.05).There were no statistically significant differences in the levels of SvO_(2) and VO_(2) between the two groups at T0(P>0.05).The SvO_(2) levels at T1,T2 and T3 in the observation group were lower than those in the control group,and the VO_(2) levels were higher than those in the control group,with statistically significant differences(P<0.05).The incidences of restlessness and shivering during recovery from anesthesia in the observation group(2.50%and 2.50%)were lower than those in the control group(15.0%and 17.50%),with statistically significant differences(P<0.05).Conclusion Ultrasound-guided serratus anterior plane block anesthesia for thoracoscopic surgery can maintain the stability and balance of hemodynamic state and oxygen metabolism,and can also reduce the occurrence of restlessness and shivering during the recovery period.It is worthy of promotion.
作者
张栩峥
蔡晓东
陈慧贞
ZHANG Xuzheng;CAI Xiaodong;CHEN Huizhen(Department of Anesthesiology,Guangdong Provincial People's Hospital Zhuhai Hospital(Zhuhai Golden Bay Center Hospital),Guangdong,Zhuhai 519000,China)
出处
《中国医药科学》
2021年第14期22-25,共4页
China Medicine And Pharmacy
基金
广东省医学科学技术研究基金项目(A2020326)。
关键词
超声引导
前锯肌平面阻滞
胸腔镜手术
氧代谢
Ultrasound guidance
Serratus anterior plane block
Thoracoscop ic surgery
Oxygen metabolism
