[1]王 婧,王 昊.在Narcotrend监测下观察胸椎旁神经阻滞对于胸腔镜手术术后谵妄的影响[J].医学信息,2021,34(20):74-77.[doi:10.3969/j.issn.1006-1959.2021.20.018]
　WANG Jing,WANG Hao.Effect of Thoracic Paravertebral Nerve Block on Postoperative Delirium AfterThoracoscopic Surgery Under Narcotrend Monitoring[J].Medical Information,2021,34(20):74-77.[doi:10.3969/j.issn.1006-1959.2021.20.018]
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在Narcotrend监测下观察胸椎旁神经阻滞对于胸腔镜手术术后谵妄的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年20期
页码:
74-77
栏目:
论著
出版日期:
2021-10-20

文章信息/Info

Title:
Effect of Thoracic Paravertebral Nerve Block on Postoperative Delirium AfterThoracoscopic Surgery Under Narcotrend Monitoring
文章编号:
1006-1959（2021）20-0074-04
作者:
王 婧; 王 昊
锦州医科大学附属第一医院麻醉科，辽宁 锦州 121001
Author(s):
WANG Jing; WANG Hao
Department of Anesthesiology,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,Liaoning,China
关键词:
胸椎旁神经阻滞; 胸腔镜手术; 麻醉深度监测; 术后谵妄
Keywords:
Thoracic paravertebral block; Thoracoscopic surgery; Anesthesia depth monitoring; Postoperative delirium
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2021.20.018
文献标志码:
A
摘要:
目的 在麻醉深度监测仪（Narcotrend）监测下观察胸椎旁神经阻滞（TPVB）对于胸腔镜手术术后谵妄（POD）的影响。方法 选取2019年1月-10月我院行全麻下胸腔镜手术的患者60例，采用随机数表法分为A组和B组，每组30例。A组行Narcotrend监测下TPVB联合全麻法，B组行Narcotrend监测下全麻法。比较两组患者VAS评分、Ramsay镇静评分、舒芬太尼用量、POD发生率、不良反应发生情况。结果 A组术后4、8、12 h VAS评分均低于B组，差异有统计学意义（P＜0.05）；A组术后4、8、12 h Ramsay镇静评分高于B组，差异有统计学意义（P＜0.05）；A组T1、T2、T3、T4 POD发生率低于B组，差异有统计学意义（P＜0.05）；A组舒芬太尼用量少于B组，差异有统计学意义（P＜0.05）；A组不良反应发生率（包括恶心呕吐、皮肤瘙痒以及呼吸抑制）均低于对照组B组，差异有统计学意义（P＜0.05）。结论 胸腔镜手术中应用TPVB技术，可阻止外周疼痛向中枢的传导，降低应激类物质的产生，减少术中阿片类药物的应用，降低POD发生率，具有安全性和可行性。
Abstract:
Objective To observe the effect of thoracic paravertebral block (TPVB) on postoperative delirium after thoracoscopic surgery under Narcotrend monitoring.Methods Sixty patients undergoing thoracoscopic surgery under general anesthesia in our hospital from January to October 2019 were randomly divided into group A and group B, with 30 cases in each group. Group A received TPVB combined with general anesthesia under Narcotrend monitoring, and group B received general anesthesia under Narcotrend monitoring. VAS score, Ramsay sedation score, sufentanil dosage, incidence of postoperative delirium and adverse reactions were compared between the two groups.Results The VAS scores at 4, 8 and 12 h after operation in group A were lower than those in group B, and the difference was statistically significant (P<0.05); the Ramsay sedation scores at 4, 8 and 12 h after operation in group A were higher than those in group B, and the difference was statistically significant (P<0.05); the incidences of T1, T2, T3 and T4 POD in group A were lower than those in group B, and the difference was statistically significant (P<0.05); the dosage of sufentanil in group A was less than that in group B, and the difference was statistically significant (P<0.05); the incidence of adverse reactions (including nausea and vomiting, pruritus and respiratory depression) in group A was lower than that in group B, and the difference was statistically significant (P<0.05).Conclusion The application of TPVB technique in thoracoscopic surgery can prevent the transmission of peripheral pain to the center, reduce the production of stress substances, reduce the application of opioids during the operation, and reduce the incidence of postoperative delirium. which is safe and feasible.

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更新日期/Last Update: 1900-01-01