中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
21期
8-10
,共3页
胸椎旁神经阻滞%神经刺激仪%全身麻醉%小切口肺癌手术
胸椎徬神經阻滯%神經刺激儀%全身痳醉%小切口肺癌手術
흉추방신경조체%신경자격의%전신마취%소절구폐암수술
Thoracic paravertebral nerve block%Peripheral nerve stimulator%General anaesthesia%Small incision lung cancer operation
目的 探讨神经刺激仪引导胸椎旁神经阻滞(thoracic paravertebral nerve block,TPVB)复合全身麻醉在小切口肺癌术中的临床应用价值.方法 选择拟行小切口肺癌手术的患者40例,ASA Ⅰ～Ⅱ级,随机分为胸椎旁神经阻滞复合全麻(P)组和全身麻醉(G)组,每组20例.记录两组麻醉诱导前(T0),气管插管后(T1),切皮即刻(T2),打开胸腔即刻(T3),单肺通气30 min(T4),关闭胸腔即刻(T5),手术结束(T6)各时点平均动脉压(MAP)和心率(HR).记录两组全身麻醉药的用量.观察两组术毕自主呼吸恢复、拔除气管导管时间及不良反应发生率.观察两组术后2、6、24 h的静息和咳嗽状态下VAS评分.结果 P组血流动力学平稳,在T2～T6各时间点的MAP、HR均低于G组(P＜0.05).P组术中全身麻醉药的用量低于G组(P＜0.05).P组自主呼吸恢复、拔除气管导管时间显著短于G组(P＜0.05);烦躁的发生率明显低于G组(P＜0.05).P组术后2、6h的静止和咳嗽状态下VAS评分均低于G组(P＜0.05).结论 神经刺激仪引导胸椎旁神经阻滞复合全身麻醉用于小切口肺癌手术全麻用药量少、苏醒快、术后镇痛时间长、并发症少,是一种值得推广的麻醉方法.
目的 探討神經刺激儀引導胸椎徬神經阻滯(thoracic paravertebral nerve block,TPVB)複閤全身痳醉在小切口肺癌術中的臨床應用價值.方法 選擇擬行小切口肺癌手術的患者40例,ASA Ⅰ～Ⅱ級,隨機分為胸椎徬神經阻滯複閤全痳(P)組和全身痳醉(G)組,每組20例.記錄兩組痳醉誘導前(T0),氣管插管後(T1),切皮即刻(T2),打開胸腔即刻(T3),單肺通氣30 min(T4),關閉胸腔即刻(T5),手術結束(T6)各時點平均動脈壓(MAP)和心率(HR).記錄兩組全身痳醉藥的用量.觀察兩組術畢自主呼吸恢複、拔除氣管導管時間及不良反應髮生率.觀察兩組術後2、6、24 h的靜息和咳嗽狀態下VAS評分.結果 P組血流動力學平穩,在T2～T6各時間點的MAP、HR均低于G組(P＜0.05).P組術中全身痳醉藥的用量低于G組(P＜0.05).P組自主呼吸恢複、拔除氣管導管時間顯著短于G組(P＜0.05);煩躁的髮生率明顯低于G組(P＜0.05).P組術後2、6h的靜止和咳嗽狀態下VAS評分均低于G組(P＜0.05).結論 神經刺激儀引導胸椎徬神經阻滯複閤全身痳醉用于小切口肺癌手術全痳用藥量少、囌醒快、術後鎮痛時間長、併髮癥少,是一種值得推廣的痳醉方法.
목적 탐토신경자격의인도흉추방신경조체(thoracic paravertebral nerve block,TPVB)복합전신마취재소절구폐암술중적림상응용개치.방법 선택의행소절구폐암수술적환자40례,ASA Ⅰ～Ⅱ급,수궤분위흉추방신경조체복합전마(P)조화전신마취(G)조,매조20례.기록량조마취유도전(T0),기관삽관후(T1),절피즉각(T2),타개흉강즉각(T3),단폐통기30 min(T4),관폐흉강즉각(T5),수술결속(T6)각시점평균동맥압(MAP)화심솔(HR).기록량조전신마취약적용량.관찰량조술필자주호흡회복、발제기관도관시간급불량반응발생솔.관찰량조술후2、6、24 h적정식화해수상태하VAS평분.결과 P조혈류동역학평은,재T2～T6각시간점적MAP、HR균저우G조(P＜0.05).P조술중전신마취약적용량저우G조(P＜0.05).P조자주호흡회복、발제기관도관시간현저단우G조(P＜0.05);번조적발생솔명현저우G조(P＜0.05).P조술후2、6h적정지화해수상태하VAS평분균저우G조(P＜0.05).결론 신경자격의인도흉추방신경조체복합전신마취용우소절구폐암수술전마용약량소、소성쾌、술후진통시간장、병발증소,시일충치득추엄적마취방법.
Objective To evaluate the anesthesia efficacy of thoracic paravertebral nerve block by nerve stimulator combined general anaesthesia on small incision lung cancer operation.Methods Forty patients undewent small incision lung cancer operation,ASA Ⅰ-Ⅱ,were randomly divided into two groups,thoracic paravertebral nerve block combined general anaesthesia group (Group P) and anaesthesia group (Group G),there were 20 cases in each group.MAP and HR of the two groups were monitored at preanesthesia (T0),post of trachea cannula (T1),Skin incision (T2),open the thoracic cavity(T3),30 min one-lung ventilation(T4),close the thoracic cavity (T5) and end of operation(T6).And the general anesthetics dosage of two group were recoreded.In postoperative,spontaneously breathing recover time,extubation time and adverse reaction were recorded.At 2,6,24 h after operation,VAS scores of patients in resting and coughing were recored.Results Hemodynamics of group P was stable.At T2-T6,the MAP and HR of group P were lower than those of group G significantly (P ＜ 0.05).The general anesthetics dosage of group P was lower than that of group G(P ＜ 0.05).In postoperative,spontaneously breathing recover time and extubation time of group P were shorter than those of group G (P ＜ 0.05),Incidence of restlessness in group P was lower than that in group G (P ＜ 0.05).At In 2 and 6 h after operation,VAS scores of group P patients in resting and coughing were lower than that of group G significantly (P ＜ 0.05).Conclusions Thoracic paravertebral nerve block by nerve stimulator combined general anaesthesia is safe and effective in small incision lung cancer operation,it is a recommendable method for its lower anesthetics dosage,early recovery,long time of analgesia and fewer adverse reaction.
