摘要
目的研究罗哌卡因复合亚甲蓝椎旁阻滞对胸腔镜肺段切除术(TPS)患者血流动力学及术后镇痛的影响。方法选取2019年1月-2021年10月于佳木斯市中心医院行TPS治疗的患者40例,按照随机数字表法分为对照组和观察组,每组20例。对照组采用罗哌卡因椎旁神经阻滞,观察组应用罗哌卡因复合亚甲蓝椎旁阻滞。比较两组血流动力学水平[心率(HR)、平均动脉压(MAP)]、术后镇痛效果[视觉模拟评分(VAS)]、术后苏醒时间、镇痛药使用量、肺损伤评分(LIS)及并发症发生情况。结果对照组围术期HR、MAP水平存在较大波动,且切皮后1 min、关胸时、拔管后30 min的HR、MAP水平高于观察组(P<0.05);观察组术后12 h安静VAS评分及咳嗽VAS评分均低于对照组(P<0.05);观察组术后苏醒时间短于对照组,且地佐辛用量少于对照组(P<0.05);术后48 h,两组LIS评分均有升高,但观察组低于对照组(P<0.05);两组并发症发生率比较,观察组低于对照组,但差异无统计学意义(P>0.05)。结论罗哌卡因复合亚甲蓝椎旁阻滞可维持TPS患者的围术期血流动力学稳定,增强术后镇痛效果,减少术后镇痛药物用量,减轻肺损伤,且不增加并发症。
Objective To study the effect of ropivacaine combined with methylene blue paravertebral block on hemodynamics and postoperative analgesia in patients undergoing thoracoscopicsegmentectomy(TPS).Methods Forty patients who underwent TPS treatment in Jiamusi Central Hospital from January 2019 to October 2021 were selected and divided into control group and observation group according to the random number table method,with 20 cases in each group.The control group was treated with ropivacaine paravertebral nerve block,and the observation group was treated with ropivacaine combined with methylene blue paravertebral block.The hemodynamic levels[heart rate(HR),mean arterial pressure(MAP)],postoperative analgesic effect[visual analogue scale(VAS)],postoperative recovery time,analgesic use,lung injury score(LIS)and complications were compared between the two groups.Results The levels of HR and MAP in the control group fluctuated greatly during the perioperative period,and the levels of HR and MAP at 1 min after skin incision,chest closure and 30 min after extubation were higher than those in the observation group(P<0.05).The quiet VAS score and cough VAS score at 12 h after operation in the observation group were lower than those in the control group(P<0.05).The recovery time of the observation group was shorter than that of the control group,and the dosage of dezocine was less than that of the control group(P<0.05).The LIS scores of the two groups increased at 48 h after operation,but the observation group was lower than the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Ropivacaine combined with methylene blue paravertebral block can maintain perioperative hemodynamic stability in patients with TPS,enhance postoperative analgesic effect,reduce postoperative analgesic drug dosage,reduce lung injury,and do not increase complications.
作者
刘忠涛
LIU Zhong-tao(Department of Anesthesiology,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)
出处
《医学信息》
2022年第18期44-47,共4页
Journal of Medical Information
