中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2014年
12期
34-36
,共3页
开胸手术%肋间神经阻滞%全身麻醉%躁动
開胸手術%肋間神經阻滯%全身痳醉%躁動
개흉수술%륵간신경조체%전신마취%조동
Thoracotomy%Intercostal nerve block%General anesthesia%Restlessness
目的：观察肋间神经阻滞联合患者自控静脉镇痛对开胸术后全麻苏醒期躁动的预防效果。方法择期开胸手术患者40例，均按相同麻醉方法进行麻醉：诱导用咪达唑仑2 mg、舒芬太尼30μg、丙泊酚1.5 mg/kg、苯磺酸顺式阿曲库铵0.15 mg/kg。麻醉维持用1%～2%七氟烷吸入、丙泊酚2～3 mg/（kg?h）、瑞芬太尼0.1～0.3μg/（kg?h）泵注，术毕随机分成对照组（A组，20例，即单纯患者自控静脉镇痛组）和实验组（B组，20例，即肋间神经阻滞+患者自控静脉镇痛组）。记录并比较各组患者性别、年龄、体质量和手术种类，观察各组患者术后苏醒期躁动发生情况，比较两组间躁动发生例数及躁动程度。结果两组患者的年龄、性别、体质量及手术种类差异均无统计学意义（P＞0.05）；B组苏醒期躁动发生率与A组比较差异有统计学意义， A组明显少于B组（P＜0.05）。结论肋间神经阻滞及术后联合患者自控静脉镇痛可明显减少开胸术后患者全麻苏醒期躁动的发生。
目的：觀察肋間神經阻滯聯閤患者自控靜脈鎮痛對開胸術後全痳囌醒期躁動的預防效果。方法擇期開胸手術患者40例，均按相同痳醉方法進行痳醉：誘導用咪達唑崙2 mg、舒芬太尼30μg、丙泊酚1.5 mg/kg、苯磺痠順式阿麯庫銨0.15 mg/kg。痳醉維持用1%～2%七氟烷吸入、丙泊酚2～3 mg/（kg?h）、瑞芬太尼0.1～0.3μg/（kg?h）泵註，術畢隨機分成對照組（A組，20例，即單純患者自控靜脈鎮痛組）和實驗組（B組，20例，即肋間神經阻滯+患者自控靜脈鎮痛組）。記錄併比較各組患者性彆、年齡、體質量和手術種類，觀察各組患者術後囌醒期躁動髮生情況，比較兩組間躁動髮生例數及躁動程度。結果兩組患者的年齡、性彆、體質量及手術種類差異均無統計學意義（P＞0.05）；B組囌醒期躁動髮生率與A組比較差異有統計學意義， A組明顯少于B組（P＜0.05）。結論肋間神經阻滯及術後聯閤患者自控靜脈鎮痛可明顯減少開胸術後患者全痳囌醒期躁動的髮生。
목적：관찰륵간신경조체연합환자자공정맥진통대개흉술후전마소성기조동적예방효과。방법택기개흉수술환자40례，균안상동마취방법진행마취：유도용미체서륜2 mg、서분태니30μg、병박분1.5 mg/kg、분광산순식아곡고안0.15 mg/kg。마취유지용1%～2%칠불완흡입、병박분2～3 mg/（kg?h）、서분태니0.1～0.3μg/（kg?h）빙주，술필수궤분성대조조（A조，20례，즉단순환자자공정맥진통조）화실험조（B조，20례，즉륵간신경조체+환자자공정맥진통조）。기록병비교각조환자성별、년령、체질량화수술충류，관찰각조환자술후소성기조동발생정황，비교량조간조동발생례수급조동정도。결과량조환자적년령、성별、체질량급수술충류차이균무통계학의의（P＞0.05）；B조소성기조동발생솔여A조비교차이유통계학의의， A조명현소우B조（P＜0.05）。결론륵간신경조체급술후연합환자자공정맥진통가명현감소개흉술후환자전마소성기조동적발생。
Objective To observe the effect of preventing restlessness by intercostal nerve block combined PCIA during general anesthesia recover post thoracotomy. Methods 40 selected patients were divided randomly into groupA(n=20, control group, only PCIA), groupB(n=20, experimental group, intercostal nerve block+PCIA)after operation.The same anesthesia induction and maintenance in two groups. Induction:Intravenous midazolam 2mg, sufentanil 30μg, propofol 1.5mg/kg and cisatracurium0.15mg/kg;maintenance:inhalated 1%-2%sevoflurane, intravenous propofol 2-3mg/(kg?h)and remifentanail 0.1-0.3μg/(kg?h). To observe and record the patient’s sex, age, weight and types of operation;To observe the patient’s restlessness during general anesthesia recover after operation. To compare the cases of restlessness and restless degree between two groups. Results There were no significant difference between two groups of age, weight, sex and types of operation(P>0.05);As compared with groupA, there was obviously difference of restlessness in groupB(P<0.05). Conclusion The method of intercostal nerve block combined PCIA can decrease risk of restlessness during general anesthesia recover post thoracotomy.
