[1]张子龙,魏雯欣,李汝泓,等.超声引导下ESPB联合PCIA与单纯PCIA对胃癌根治术患者术后镇痛效果的比较[J].医学信息,2018,(20):61-64.[doi:10.3969/j.issn.1006-1959.2018.20.018]
 ZHANG Zi-long,WEI Wen-xin,LI Ru-hong,et al.Comparison of Postoperative Analgesic Effects of ESPB Combined with PCIA and PCIA Alone in Patients with Radical Resection of Gastric Cancer under Ultrasound Guidance[J].Medical Information,2018,(20):61-64.[doi:10.3969/j.issn.1006-1959.2018.20.018]
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超声引导下ESPB联合PCIA与单纯PCIA对胃癌根治术患者术后镇痛效果的比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期数:
2018年20期
页码:
61-64
栏目:
论著
出版日期:
2018-10-15

文章信息/Info

Title:
Comparison of Postoperative Analgesic Effects of ESPB Combined with PCIA and PCIA Alone in Patients with Radical Resection of Gastric Cancer under Ultrasound Guidance
文章编号:
1006-1959(2018)20-0061-04
作者:
张子龙魏雯欣李汝泓周 腾
承德医学院附属医院麻醉科,河北 承德 067000
Author(s):
ZHANG Zi-longWEI Wen-xinLI Ru-hongZHOU Teng
Department of Anesthesiology,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China
关键词:
胃癌根治术竖脊肌平面阻滞术后自控静脉镇痛
Keywords:
Radical resection of gastric cancerVertical spinal muscle blockPostoperative patient-controlled intravenous analgesia
分类号:
R735.2
DOI:
10.3969/j.issn.1006-1959.2018.20.018
文献标志码:
A
摘要:
目的 比较经超声引导下的T7水平竖脊肌平面阻滞联合静脉自控镇痛与单纯静脉自控镇痛在胃癌根治术术后镇痛的临床效果。方法 选择我院拟于择期全身麻醉下行胃癌根治术患者50例,随机分为实验组(EP组)和对照组(P组),各25例。实验组于麻醉诱导开始前行超声引导下双侧T7水平竖脊肌平面阻滞,术后联合PCIA镇痛,对照组单纯行PCIA镇痛。比较两组患者术后2、6、12、24、48 h VAS评分和BCS评分,记录术后24、48 h内镇痛泵自控给药次数,第一次自控镇痛至手术结束时间,术后24、48 h内患者恶心呕吐、头晕、呼吸抑制、皮肤瘙痒等不良反应发生情况。结果 ①EP组后2、6、12、24、48 h VAS评分与BCS评分均低于P组,差异有统计学意义(P<0.05);②EP组第一次自控镇痛至手术结束时间为(12.72±8.60)h,P组第一次自控镇痛至手术结束时间为(0.93±0.24)h,差异有统计学意义(P<0.05);③EP组术后24、48 h内自控给药次数分别为(1.20±0.65)次,(2.52±1.45)次,P组术后24、48 h自控给药次数分别为(17.68±3.69)次,(24.56±5.1)次,差异有统计学意义(P<0.05);④EP组术后不良反应发生率低于P组,差异有统计学意义(P<0.05)。结论 超声引导下的竖脊肌平面阻滞联合静脉自控镇痛模式可为胃癌根治术患者提供良好的术后镇痛,同时可以减少阿片类药物的用量,进而改善术后不良反应。
Abstract:
Objective To compare the clinical effects of T7 vertical spinal muscle plane block combined with patient-controlled intravenous analgesia and alone in postoperative analgesia after radical resection of gastric cancer.Methods 50 patients with gastric cancer undergoing radical gastrectomy under general anesthesia in our hospital were randomly divided into experimental group(EP group)and control group(P group)with 25 cases each.The experimental group underwent ultrasound-guided bilateral T7 level vertical spinae block before the start of anesthesia induction,combined with PCIA analgesia after operation,while the control group received PCIA analgesia alone.The VAS scores and BCS scores of the two groups were compared at 2,6,12,24,48 h after operation.The number of self-controlled administration of analgesia pumps was recorded within 24 and 48 h after surgery.The first self-controlled analgesia to the end of surgery.Adverse reactions such as nausea and vomiting,dizziness,respiratory depression,and itching of the skin occurred within 24 h and 48 h.Results ①The scores of VAS and BCS in EP group were significantly lower than those in P group ,the difference was statistically significant(P<0.05);②The first self-controlled analgesia to the end of surgery in the EP group was(12.72±8.60)h,and the first self-controlled analgesia in the P group was(0.93±0.24)h,the difference was statistically significant(P<0.05).③The number of self-administered doses in the EP group was(1.20±0.65)times,(2.52±1.45)times within 24 and 48 h after operation,and the number of self-administered doses in the P group at 24 and 48 h after surgery was(17.68±3.69)times,(24.56±5.1)times,the difference was statistically significant(P<0.05);④The incidence of adverse reactions in the EP group was lower than that in the P group,the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided vertical spinal muscle block combined with patient-controlled intravenous analgesia can provide good postoperative analgesia for patients undergoing radical gastrectomy,reduce the amount of opioid drugs,and improve postoperative adverse reactions.

参考文献/References:

[1]程庆华.老年胃癌手术治疗效果分析[J].中国农村卫生事业管理,2011,31(7):768-769. [2]刘喜成,张中军,李亚丽,等.罗哌卡因在老年腹腔镜辅助胃癌根治术患者术后镇痛中的应用[J].广东医学,2013,34(17):2709-2710. [3]马丹旭,任惠龙,芮燕.等.超声引导下单次竖脊肌平面阻滞对胸腔镜下肺叶切除患者静脉自控镇痛效果的影响[J].临床麻醉学杂志,2017,33(10):965-967. [4]倪家骧,樊碧发,薛富善.临床疼痛治疗技术[M].北京:科学技术文献出版社,2005:3-13. [5]Sanjib Adhikary,Ki Jinn Chin,Mauricio Forero,et al.The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP)blocks in patients having ventral hernia repair[J].Anaesthesia,2017,72(4):452-460. [6]张华.人竖脊肌内神经分布、肌构筑、肌梭和神经入肌点定位研究[D].遵义医学院,2012. [7]Hamilton DL,Manickam B.Erector Spinae Plane Block for pain relief in rib fractures[J].British Journal of Anaesthesia,2017(118):473-474. [8]Hamilton DL,Manickam B.Is the erector spinae plane(ESP) block a sheath block[J].Anaesthesia 2017(72):910-924.

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更新日期/Last Update: 2018-11-09