超声引导双侧胸椎旁神经阻滞用于开放性胃癌根治术患者的镇痛效果观察(1)
摘 要：目的 觀察超声引导双侧T7-9椎旁神经阻滞用于开放性胃癌根治术患者的镇痛效果。方法 选择择期开放性胃癌根治手术患者50例，随机数字表法随机分为全麻组(G组)和全麻复合椎旁神经阻滞组(P组)，各25例。G组行气管插管静脉全麻，P组于全麻前行超声引导椎旁神经阻滞。记录基础值(T0)、手术前(T1)、手术5 min(T2)、手术探查时(T3)、手术20 min(T4)、手术1 h(T5)、手术结束(T6)各时间点的MAP和HR，患者术后2 h、4 h、8 h、12 h、24 h、48 h的静息和活动时的VAS评分，术中及术后镇痛药物用量，气管拔管时间，PACU停留时间，观察相关并发症的发生率。结果 与G组对比，P组术后4 h、8 h、12 h、24 h的静息及12 h内的活动时VAS评分降低，气管拔管时间缩短，术后躁动发生率降低，差异均具有统计学意义(P<0.05)，术中舒芬太尼及术后追加镇痛药用量降低，T2、T3时间点的MAP及T2、T3、T4、T5时间点的HR较低，更为平稳。结论 超声引导双侧T7-9椎旁神经阻滞用于开放性胃癌根治手术患者具有良好的镇痛作用。
, http://www.100md.com
关键词：双侧椎旁神经阻滞；超声引导；镇痛；胃癌根治术
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.11.025
文章编号：1006-1959(2018)11-0080-05
Observation on Analgesic Effect of Bilateral Thoracic Paravertebral Nerve Block Guided by Ultrasound in Patients Undergoing Open Radical Gastrectomy for Gastric Cancer
RAO Jin，ZONG Zhi-jun，GAO Zhi-xin，WANG Yi-qiao，LI Yuan-hai
, 百拇医药
(Department of Anesthesiology，First Affiliated Hospital of Anhui Medical University，Hefei 230022，Anhui，China)
Abstract：Objective To observe the effect of ultrasound guided bilateral T7-9paravertebral nerve block for analgesia in patients undergoing open radical gastrectomy for gastric cancer.Methods A total of 50 patients undergoing elective open radical gastrectomy for gastric cancer were randomly selected and randomized into general anesthesia group(G group)and general anesthesia paravertebral nerve block group(P group)，25 cases each.In the G group，tracheal intubation was performed intravenously，and in the P group， ultrasound guided paravertebral nerve block was performed before general anesthesia.Record baseline(T0)，preoperative(T1)，5 min(T2)， surgical exploration(T3)，MAP and HR at 20 min(T4)，1 h(T5)，and the end of the operation(T6)at each time point after surgery，and resting at 2 h，4 h，8 h，12 h，24 h，and 48 h after surgery VAS scores at and during exercise，intraoperative and postoperative analgesic drug usage，tracheal extubation time，and PACU retention time were used to observe the incidence of related complications.Results Compared with group G，VAS scores decreased at 4 h，8 h，12 h，24 h after operation，and VAS scores within 12 h after operation，and tracheal extubation time was shortened， and the incidence of postoperative agitation was decreased，the difference was statistically significant(P<0.05)，intraoperative sufentanil and postoperative additional analgesics decreased，MAP at T2，T3，and HR at T2，T3，T4，and T5 were lower and more stable.Conclusion Ultrasound-guided bilateral T7-9paravertebral nerve block has a good analgesic effect in open radical gastrectomy for gastric cancer patients., http://www.100md.com(饶瑾 宗志军 高之心 王义桥 李元海)
, http://www.100md.com
关键词：双侧椎旁神经阻滞；超声引导；镇痛；胃癌根治术
中图分类号：R614 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.11.025
文章编号：1006-1959(2018)11-0080-05
Observation on Analgesic Effect of Bilateral Thoracic Paravertebral Nerve Block Guided by Ultrasound in Patients Undergoing Open Radical Gastrectomy for Gastric Cancer
RAO Jin，ZONG Zhi-jun，GAO Zhi-xin，WANG Yi-qiao，LI Yuan-hai
, 百拇医药
(Department of Anesthesiology，First Affiliated Hospital of Anhui Medical University，Hefei 230022，Anhui，China)
Abstract：Objective To observe the effect of ultrasound guided bilateral T7-9paravertebral nerve block for analgesia in patients undergoing open radical gastrectomy for gastric cancer.Methods A total of 50 patients undergoing elective open radical gastrectomy for gastric cancer were randomly selected and randomized into general anesthesia group(G group)and general anesthesia paravertebral nerve block group(P group)，25 cases each.In the G group，tracheal intubation was performed intravenously，and in the P group， ultrasound guided paravertebral nerve block was performed before general anesthesia.Record baseline(T0)，preoperative(T1)，5 min(T2)， surgical exploration(T3)，MAP and HR at 20 min(T4)，1 h(T5)，and the end of the operation(T6)at each time point after surgery，and resting at 2 h，4 h，8 h，12 h，24 h，and 48 h after surgery VAS scores at and during exercise，intraoperative and postoperative analgesic drug usage，tracheal extubation time，and PACU retention time were used to observe the incidence of related complications.Results Compared with group G，VAS scores decreased at 4 h，8 h，12 h，24 h after operation，and VAS scores within 12 h after operation，and tracheal extubation time was shortened， and the incidence of postoperative agitation was decreased，the difference was statistically significant(P<0.05)，intraoperative sufentanil and postoperative additional analgesics decreased，MAP at T2，T3，and HR at T2，T3，T4，and T5 were lower and more stable.Conclusion Ultrasound-guided bilateral T7-9paravertebral nerve block has a good analgesic effect in open radical gastrectomy for gastric cancer patients., http://www.100md.com(饶瑾 宗志军 高之心 王义桥 李元海)