超声引导下肋间神经阻滞联合全身麻醉在老年原发性肺癌术后镇痛中的应用

doi:10.3969/j.issn.1003-9198.2021.02.016

摘要/Abstract

摘要： 目的探讨超声引导下肋间神经阻滞联合全身麻醉在老年原发性肺癌术后镇痛中的应用及对VAS评分的影响。方法选择2018年2月至2020年3月老年原发性肺癌病人132例作为对象,按照麻醉方式的不同分为对照组(n=66例)和观察组(n=66例)。对照组采用全身麻醉,观察组实施超声引导下肋间神经阻滞联合全身麻醉。比较2组病人诱导前、拔管后生命体征相关指标情况,术后不同时间点VAS评分、舒适度及镇静评分情况。结果观察组拔管后DBP、SBP及心率均低于对照组(P<0.05),术后血氧饱和度高于对照组(P<0.05);观察组术后2、8、24、48 h卧床、活动后VAS评分均低于对照组(P<0.05或P<0.01);观察组术后1、2 h镇静评分低于对照组,舒适度评分高于对照组(P<0.05)。结论超声引导下肋间神经阻滞联合全身麻醉能够明显减轻病人术后疼痛,提高病人的舒适度,降低应激反应程度,值得推广应用。

关键词: 全身麻醉, 超声引导下肋间神经阻滞, 原发性肺癌, 视觉模拟评分, 老年人

Abstract: Objective To investigate the application of ultrasound-guided intercostal nerve block combined with general anesthesia in postoperative analgesia of elderly patients with lung cancer and its influence on visual analogue scale (VAS) score. Methods A total of 132 elderly patients with primary lung cancer from February 2018 to March 2020 were selected and divided into the control group (n= 66) and the observation group (n=66) according to different anesthesia methods. The control group was given general anesthesia, while the observation group was given ultrasound-guided intercostal nerve block combined with general anesthesia. The vital signs related indexes before induction and after extubation, VAS score at different time points after operation, comfort degree and sedation at different time points after operation were compared between the two groups. Results After extubation, the levels of diastolic blood pressure, systolic blood pressure and heart rate in the observation group were lower than those in the control group (P<0. 05), and the blood oxygen saturation after operation was higher than that in the control group (P<0. 05); The VAS scores in the observation group 2, 8, 24, 48 h after operation were lower than those in the control group (P<0. 05 or P<0. 01). The sedation scores in the observation group 1 and 2 h after operation were lower, and the comfort degree was higher than those in the control group (P<0. 05). Conclusions Ultrasound-guided intercostal nerve block combined with general anesthesia can significantly alleviate postoperative pain, improve the comfort of patients, reduce the degree of stress reaction, and obtain good results, which is worthy of promotion and application.

Key words: general anesthesia, ultrasound-guided intercostal nerve block, primary lung cancer, visual analogue scale, aged

中图分类号:

王美青, 刘政呈, 殷飞, 雷钧, 赵维珊, 孙杨. 超声引导下肋间神经阻滞联合全身麻醉在老年原发性肺癌术后镇痛中的应用[J]. 实用老年医学, 2021, 35(2): 173-176.

WANG Mei-qing, YIN Fei, LEI Jun, ZHAO Wei-shan, SUN Yang, LIU Zheng-cheng. Application of ultrasound-guided intercostal nerve block combined with general anesthesia in postoperative analgesia of elderly patients with primary lung cancer[J]. Practical Geriatrics, 2021, 35(2): 173-176.

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