胸椎旁神经阻滞用于高原地区老年开胸患者术后镇痛的临床观察

发布时间：2018-05-14 02:20

本文选题：神经传导阻滞 + 胸廓切开术　；参考：《重庆医学》2015年22期

【摘要】：目的比较胸椎旁神经阻滞和静脉术后镇痛用于高原地区老年开胸患者术后镇痛的临床效果。方法选择在全身麻醉下择期行开胸手术的老年患者120例,根据术毕所采用镇痛方式的不同分为胸椎旁神经阻滞组(A组)和静脉镇痛组(B组)。A组于术毕拔管后在超声引导下行胸椎旁神经阻滞,给予盐酸罗哌卡因和舒芬太尼混合液;B组于术毕缝皮前开启经静脉自控镇痛(舒芬太尼和雷莫司琼)。观察两组患者分别于术后1h(t1)、2h(t2)、3h(t3)、12h(t4)和24h(t5)安静及咳嗽时视觉模拟疼痛评分(VAS)、术后镇痛满意度、术后不良反应发生情况。结果 A组患者在超声引导下顺利完成胸椎旁神经阻滞,未见与穿刺引起的相关并发症。与B组比较,A组术后VAS评分明显降低(P0.05);镇痛效果好,满意度高(P0.01),恶心呕吐及嗜睡等不良反应发生率低(P0.05)。结论超声引导下盐酸罗哌卡因复合舒芬太尼胸椎旁神经阻滞用于高原地区老年开胸患者术后镇痛安全、有效且不良反应少,患者总体满意度高。
[Abstract]:Objective to compare the clinical effects of thoracic paravertebral block and intravenous analgesia for postoperative analgesia in elderly patients with thoracotomy in high altitude areas. Methods 120 elderly patients undergoing thoracotomy under general anesthesia were selected and divided into.A group (group A) and intravenous analgesia group (group B) group.A according to the different analgesic methods adopted at the end of the operation. The mixture of ropivacaine and sufentanil was given under ultrasound guidance after ultrasound guidance. The B group opened the intravenous analgesia (sufentanil and Lei Mo Si Qiong) before the operation of the suture. The two groups were observed in the postoperative 1H (T1), 2h (T2), 3h (T3), 12h (T4), 24h (T5) and the visual analogue pain in the cough. Scores (VAS), postoperative analgesia satisfaction and postoperative adverse reaction occurred. Results group A patients successfully completed paravertebral paravertebral block under ultrasound guidance and no related complications caused by puncture. Compared with group B, the VAS score in group A was significantly lower (P0.05); the analgesic effect was good, the satisfaction was high (P0.01), nausea, vomiting and lethargy. The rate of birth was low (P0.05). Conclusion ultrasound guided ropivacaine combined with sufentanil paravertebral nerve block was used for the safety of postoperative analgesia in elderly patients with thoracotomy in plateau areas, effective and less adverse reactions, and the overall satisfaction of the patients was high.

【作者单位】：青海省中医院麻醉科;
【分类号】：R614

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