超声引导下肋间神经阻滞在单侧乳房肿块切除术中的应用

发布时间：2018-04-13 22:06

本文选题：超声引导 + 肋间神经阻滞　；参考：《临床麻醉学杂志》2015年08期

【摘要】：目的观察超声引导下肋间神经阻滞在单侧乳房肿块切除术中的应用效果。方法60例择期拟行单侧乳房肿块切除术女性患者,年龄19~42岁,BMI 17.9~26.8kg/m2,随机分为超声引导组(U组)和传统定位组(N组),均行肋间神经阻滞,局麻药均为0.25%左旋布比卡因20ml。观察阻滞操作时间,阻滞起效时间,阻滞完善时间,手术开始切皮时VAS评分,镇痛维持时间,手术中牵拉深部组织时VAS评分,镇痛不全和局麻药中毒情况。结果与N组比较,U组操作时间明显延长,阻滞起效时间明显缩短,手术开始切皮时VAS评分明显降低,阻滞完善时间明显缩短,镇痛维持时间明显延长,术中牵拉深部组织时VAS评分明显降低,镇痛不全及麻醉后出现头晕明显减少(P0.05)。两组均未出现恶心呕吐症状。结论超声引导下肋间神经阻滞在单侧乳房肿块切除术中的麻醉效果明显优于传统定位。
[Abstract]:Objective to observe the effect of intercostal nerve block guided by ultrasound in unilateral mastectomy.Methods 60 female patients with unilateral breast mass resection, aged 1942 years, were randomly divided into two groups: ultrasound guided group (n = 60) and traditional positioning group (n = 20). All patients were treated with intercostal nerve block. The local anesthetics were 0.25% levobupivacaine 20ml.The operation time of block, the onset time of block, the perfect time of block, the VAS score at the beginning of operation, the time of maintaining analgesia, the VAS score of pulling deep tissue during operation, the incomplete analgesia and the poisoning of anesthetic were observed.Results compared with group N, the operation time and the onset time of block were significantly prolonged, the VAS score was significantly decreased, the perfect time of block was shortened, and the maintenance time of analgesia was significantly prolonged at the beginning of operation.The VAS score of deep tissue was significantly decreased, the analgesia was not complete and the dizziness was significantly decreased after anesthesia (P 0.05).There was no nausea and vomiting in both groups.Conclusion Ultrasound-guided intercostal nerve block is more effective than traditional localization in unilateral mastectomy.
【作者单位】：江苏省昆山市第二人民医院麻醉科;
【分类号】：R614

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