[1]张隆盛,林旭林,张欢楷,等.前锯肌平面阻滞联合静脉镇痛用于肺叶切除术患者的效果[J].医学信息,2020,33(18):54-58.[doi:10.3969/j.issn.1006-1959.2020.18.017]
　ZHANG Long-sheng,LIN Xu-lin,ZHANG Huan-kai,et al.Effect of Serratus Anterior Plane Block Combined with Intravenous Analgesia in Patients Undergoing Lobectomy[J].Medical Information,2020,33(18):54-58.[doi:10.3969/j.issn.1006-1959.2020.18.017]
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前锯肌平面阻滞联合静脉镇痛用于肺叶切除术患者的效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年18期
页码:
54-58
栏目:
论著
出版日期:
2020-09-15

文章信息/Info

Title:
Effect of Serratus Anterior Plane Block Combined with Intravenous Analgesia in Patients Undergoing Lobectomy
文章编号:
1006-1959（2020）18-0054-05
作者:
张隆盛; 林旭林; 张欢楷; 等
（揭阳市人民医院麻醉科，广东 揭阳 522000）
Author(s):
ZHANG Long-sheng; LIN Xu-lin; ZHANG Huan-kai; et al
(Department of Anesthesiology,Jieyang People’s Hospital,Jieyang 522000,Guangdong,China)
关键词:
前锯肌平面阻滞; 胸腔镜肺癌手术; 术后镇痛; 免疫功能
Keywords:
Serratus anterior plane block; Thoracoscopic lung cancer surgery; Postoperative analgesia; Immune function
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2020.18.017
文献标志码:
A
摘要:
目的 观察超声引导下前锯肌平面阻滞联合静脉镇痛用于肺叶切除术患者的效果。方法 选择2016年9月~2020年5月在我院行择期胸腔镜肺癌根治术患者90例，采用随机数字表法分为前锯肌平面阻滞联合静脉镇痛组（S组）、硬膜外组（E组）、静脉镇痛组（V组）。三组患者均采用支气管插管静脉全身麻醉，S组在麻醉诱导前行超声引导下患侧前锯肌平面阻滞，E组行硬膜外穿刺操作，V组不行任何穿刺操作。术后S组、V组采用静脉自控镇痛（PCIA），E组采用硬膜外自控镇痛（PCEA）。记录三组术中丙泊酚、瑞芬太尼和舒芬太尼用量，术后2、4、8、12、24、48 h静止和咳嗽疼痛视觉模拟量表（VAS）评分，术后48 h内镇痛泵按压次数和氟比洛芬酯补救性镇痛例数及麻醉诱导前、术后24、72 h自然杀伤细胞（NK细胞）、CD4+T淋巴细胞及CD8+T淋巴细胞百分比。结果 S组、E组丙泊酚、瑞芬太尼和舒芬太尼用量少于V组，差异有统计学意义（P＜0.05）；S组、E组术后2、4、8、12、24 h静止和咳嗽疼痛VAS评分低于V组，差异有统计学意义（P＜0.05）；S组、E组48 h内PCIA按压次数和补救性镇痛例数少于V组，差异有统计学意义（P＜0.05）；S组、E组术后24 h CD4+T淋巴细胞、CD8+T淋巴细胞和NK细胞百分比高于V组，差异有统计学意义（P＜0.05）。结论 与单纯静脉镇痛相比，前锯肌平面阻滞联合静脉自控镇痛的多模式镇痛方法和连续硬膜外镇痛均可以为胸腔镜肺癌手术患者提供有效完善的术后镇痛，减少围术期镇静镇痛药用量，优化免疫抑制状态。
Abstract:
Objective To observe the effect of ultrasound-guided serratus anterior plane block combined with intravenous analgesia in patients undergoing lobectomy.Methods 90 patients who underwent elective thoracoscopic radical resection of lung cancer in our hospital from September 2016 to May 2020 were selected and divided into serratus anterior plane block combined with intravenous analgesia group (group S),Epidural group (E group), intravenous analgesia group (V group).3 groups of patients underwent general anesthesia with bronchial intubation, group S underwent ultrasound-guided serratus anterior plane block on the affected side before induction of anesthesia, group E underwent epidural puncture, and group V did not perform any puncture. Postoperative patient-controlled intravenous analgesia (PCIA) was used in group S and V, and patient-controlled epidural analgesia (PCEA) was used in group E.Record the three groups of intraoperative propofol, remifentanil and sufentanil dosage, postoperative 2, 4, 8, 12, 24, 48 h static and cough pain visual analogue scale (VAS) scores,the number of analgesic pump compressions and flurbiprofen axetil salvage analgesia within 48 hours after operation, natural killer cells (NK cells), CD4+T lymph nodes before anesthesia induction, 24 and 72 h after operation Percentage of cells and CD8+ T lymphocytes.Results The dosages of propofol, remifentanil, and sufentanil in group S and E were less than those in group V,the difference was statistically significant (P<0.05);The VAS scores of static and cough pain at 2, 4, 8, 12, 24 h after operation in group S and E were lower than those in group V, the difference was statistically significant (P＜0.05); the number of PCIA compressions within 48 h in group S and E The number of patients with salvage analgesia was less than that of group V,the difference was statistically significant (P＜0.05); the percentages of CD4+ T lymphocytes, CD8+ T lymphocytes and NK cells were higher than that of V group at 24 h after surgery in group S and E Group, the difference was statistically significant (P<0.05).Conclusion Compared with simple intravenous analgesia, the serratus anterior plane block combined with intravenous patient-controlled analgesia and continuous epidural analgesia can provide effective and perfect postoperaqtive analgesia for patients undergoing thoracoscopic lung cancer surgery. Reducing the amount of sedative analgesics during the perioperative period and optimizing the immunosuppressive state.

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更新日期/Last Update: 1900-01-01