超声引导下椎旁神经阻滞应用于老年人开胸手术术后镇痛效果
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摘要
目的探究老年开胸手术患者接受超声引导下椎旁神经阻滞术后镇痛的效果。方法以老年开胸手术患者48例为研究对象,所选时间为2017年8月—2018年8月,以计算机随机化法分组,随机分为对照组和实验组,每组24例患者,其中对照组实施全身麻醉,实验组则实施超声引导下椎旁神经阻滞干预,分析2组老年开胸手术患者镇痛的效果。结果实验组老年开胸手术患者术后2、12、24、48 h的疼痛评分分别为(2.12±0.31)分、(3.03±0.15)分、(2.67±0.34)分、(1.31±0.37)分均低于对照组的(4.98±0.26)分、(5.15±0.20)分、(3.67±0.40)分、(3.11±0.36)分,差异有统计学意义(t=34.629 6, 41.543 3, 9.331 8, 17.081 6, P<0.05);实验组的不良反应几率(12.50%)较对照组不良反应几率(37.50%)低(χ2=4.000,P<0.05);老年开胸手术患者患者的MAP、HR稳定性实验组也明显优于对照组,差异有统计学意义(P<0.05)。结论老年开胸手术患者接受超声引导下椎旁神经阻滞干预,其术后镇痛效果较好,可将其镇痛期间的相关不良反应减轻,且可对手术中生命体征的稳定性维持。
Objective To investigate the effect of ultrasound-guided analgesia after paravertebral nerve block in elderly patients undergoing thoracotomy. Methods Forty-eight patients with open thoracotomy were enrolled in the study. The selected time was from August 2017 to August 2018. They were randomly divided into control group and experimental group, with 24 patients in each group. The control group underwent general anesthesia, and the experimental group underwent ultrasound-guided paravertebral nerve block intervention to analyze the analgesic effect of the two groups of elderly patients undergoing thoracotomy. Results The pain scores of the elderly patients undergoing thoracotomy at 2,12, 24 and 48 h were(2.12±0.31)points,(3.03±0.15)points,(2.67±0.34)points and(1.31±0.37)points, respectively,which were lower than the(4.98±0.26)points and(5.15±0.20)points,(3.67±0.40)points,(3.11±0.36)points of the control group, the difference was statistically significant(t=34.629 6, 41.543 3, 9.331 8, 17.081 6, P<0.05); the adverse reaction rate of the experimental group(12.50%) was lower than that of the control group(37.50%)(χ2=4.000, P<0.05).The MAP and HR stability test group of elderly patients undergoing thoracotomy was also significantly better than the control group, and the difference was statistically significant(P <0.05). Conclusion Patients undergoing ultrasound-guided paravertebral nerve block intervention in elderly patients undergoing thoracotomy have better postoperative analgesia, which can alleviate the adverse reactions during analgesia and maintain the stability of vital signs during surgery.
Objective To investigate the effect of ultrasound-guided analgesia after paravertebral nerve block in elderly patients undergoing thoracotomy. Methods Forty-eight patients with open thoracotomy were enrolled in the study. The selected time was from August 2017 to August 2018. They were randomly divided into control group and experimental group, with 24 patients in each group. The control group underwent general anesthesia, and the experimental group underwent ultrasound-guided paravertebral nerve block intervention to analyze the analgesic effect of the two groups of elderly patients undergoing thoracotomy. Results The pain scores of the elderly patients undergoing thoracotomy at 2,12, 24 and 48 h were(2.12±0.31)points,(3.03±0.15)points,(2.67±0.34)points and(1.31±0.37)points, respectively,which were lower than the(4.98±0.26)points and(5.15±0.20)points,(3.67±0.40)points,(3.11±0.36)points of the control group, the difference was statistically significant(t=34.629 6, 41.543 3, 9.331 8, 17.081 6, P<0.05); the adverse reaction rate of the experimental group(12.50%) was lower than that of the control group(37.50%)(χ2=4.000, P<0.05).The MAP and HR stability test group of elderly patients undergoing thoracotomy was also significantly better than the control group, and the difference was statistically significant(P <0.05). Conclusion Patients undergoing ultrasound-guided paravertebral nerve block intervention in elderly patients undergoing thoracotomy have better postoperative analgesia, which can alleviate the adverse reactions during analgesia and maintain the stability of vital signs during surgery.
引文
[1]何旭秀.胸椎旁神经阻滞用于高原地区老年开胸患者术后镇痛的临床观察[J].重庆医学,2015,44(22):3121-3122,3123.
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[3]庆淑梅,曹亚楠,孙振涛,等.椎旁神经阻滞用于开胸术老年患者超前镇痛的效果[J].中华麻醉学杂志,2016,36(2):168-170.
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[5]姜勇,唐晓慧.高原低氧环境下胸椎旁神经阻滞对老年开胸患者应激反应、循环功能及术后镇痛的影响[J].中国老年学杂志,2017,37(10):2497-2500.
[6]曾凌竹,余云明.右美托咪定用于胸椎旁神经阻滞对老年开胸手术患者氧化应激及炎性反应的影响[J].现代中西医结合杂志,2017,26(32):3629-3632.
[7]陈鹏,王鹏,黄庆先,等.超声引导胸椎旁神经阻滞复合右美托咪定用于开胸术老年患者超前镇痛的效果[J].齐齐哈尔医学院学报,2017,38(5):537-538.
[8]罗玉金,贺涛,伍国芳,等.超声引导胸椎旁神经阻滞对老年患者开胸手术后苏醒质量及快速康复的影响[J].医疗装备,2018,31(16):4-6.
[9]叶伟光,卜丹,王天龙,等.超声引导连续胸椎旁神经阻滞对老年患者开胸术后镇痛的效果[J].北京医学,2017,39(3):236-239.
[10]麦伟良,黄坚,张敏森,等.探讨超声引导下椎旁神经阻滞在老年患者开胸手术术中及术后的镇痛效果[J].中华临床医师杂志:电子版,2016,10(4):60-61.
[11]刘伟,孙前闯,宋智敏,等.超声引导下椎旁神经阻滞在老年人开胸手术术后镇痛中的疗效[J].中国老年学杂志,2015,35(7):1854-1855.
[12]唐艳平.老年患者开胸手术采用椎旁神经阻滞术后镇痛的有效性、安全性及康复意义[J].首都食品与医药,2018,25(4):13-14.
[2]赵晓东.探讨超声引导下椎旁神经阻滞在老年患者开胸手术术中及术后的镇痛效果[J].影像研究与医学应用,2018,2(4):101-102.
[3]庆淑梅,曹亚楠,孙振涛,等.椎旁神经阻滞用于开胸术老年患者超前镇痛的效果[J].中华麻醉学杂志,2016,36(2):168-170.
[4]陈鹏,王鹏.超声引导下连续胸椎旁阻滞对老年食管癌患者术后早期认知功能的影响[J].齐齐哈尔医学院学报,2017,38(7):766-768.
[5]姜勇,唐晓慧.高原低氧环境下胸椎旁神经阻滞对老年开胸患者应激反应、循环功能及术后镇痛的影响[J].中国老年学杂志,2017,37(10):2497-2500.
[6]曾凌竹,余云明.右美托咪定用于胸椎旁神经阻滞对老年开胸手术患者氧化应激及炎性反应的影响[J].现代中西医结合杂志,2017,26(32):3629-3632.
[7]陈鹏,王鹏,黄庆先,等.超声引导胸椎旁神经阻滞复合右美托咪定用于开胸术老年患者超前镇痛的效果[J].齐齐哈尔医学院学报,2017,38(5):537-538.
[8]罗玉金,贺涛,伍国芳,等.超声引导胸椎旁神经阻滞对老年患者开胸手术后苏醒质量及快速康复的影响[J].医疗装备,2018,31(16):4-6.
[9]叶伟光,卜丹,王天龙,等.超声引导连续胸椎旁神经阻滞对老年患者开胸术后镇痛的效果[J].北京医学,2017,39(3):236-239.
[10]麦伟良,黄坚,张敏森,等.探讨超声引导下椎旁神经阻滞在老年患者开胸手术术中及术后的镇痛效果[J].中华临床医师杂志:电子版,2016,10(4):60-61.
[11]刘伟,孙前闯,宋智敏,等.超声引导下椎旁神经阻滞在老年人开胸手术术后镇痛中的疗效[J].中国老年学杂志,2015,35(7):1854-1855.
[12]唐艳平.老年患者开胸手术采用椎旁神经阻滞术后镇痛的有效性、安全性及康复意义[J].首都食品与医药,2018,25(4):13-14.