单孔胸腔镜术后应用肋间神经联合前锯肌阻滞的镇痛效果分析.docVIP

单孔胸腔镜术后应用肋间神经联合前锯肌阻滞的镇痛效果分析

【摘要】目的观察肋间神经阻滞联合前锯肌阻滞对单孔胸腔镜术后镇痛的效果。方法纳入我院2018年3月~2019年3月接受单孔胸腔镜手术患者共60例，按照随机数字表法分为两组：观察组（直视下肋间神经阻滞联合超声引导下前锯肌阻滞）30例，男18例，女12例，平均年龄52.30±16.19岁；对照组（超声引导下前锯肌阻滞）30例，男15例，女15例，平均年龄51.43±15.78岁。记录患者术后4h、12h、24h、48h疼痛VAS评分、PCIA按压次数，补救性用药次数；观察麻醉相关副作用，肺部并发症情况。结果观察组在术后12h、24h疼痛VAS评分，PCIA按压次数，补救性用药次数，肺部并发症发生率均低于对照组（P＜0.05），在术后4h、48h疼痛VAS评分，麻醉相关副作用方面两组间差异无统计学意义（P＞0.05）。结论肋间神经阻滞联合前锯肌阻滞有效减轻单孔胸腔镜术后患者疼痛，降低患者肺部并发症，有利于患者快速康复。

【关键词】肋间神经阻滞前锯肌阻滞单孔胸腔镜镇痛效果

Analysisofanalgesiceffectofintercostalnervecombinedwithanteriorserratusblockaftersingle-holethoracoscopicsurgery

【Abstract】Objective：toobservetheanalgesiceffectofintercostalnerveblockcombinedwithserratusanteriormuscleblockafteruniportalvideo-assistedthoracicsurgery.Methods：?Werecuited60patientswhoaccepteduniportalvideo-assistedthoracicsurgeryFromMarch2018toMarch2019.Theyweredividedintotwogroupsaccordingtothedigitaltable.observationgroup，inwhich30patients(18males,12females,withameanageof52.30±16.19yearsold)receivedintercostalnerveblockcombinedwithultrasound-guidedanteriorserratusmuscleblock.Andinthecontrolgroup,inwhich30patients(15males,15females,withameanageof51.43±15.78yearsold)onlyreceivedultrasound-guidedanteriorserratusblock.Thevasscoresofpainat4h,12h,24h,48hafteroperation,thetimesofPCIApressingandthetimesofadditionalmedicationwererecorded,andthesideeffectsofanesthesiaandpulmonarycomplicationswereobserved.Results：At4h,12h,24hafteroperation,thepainvasscores,thetimesofPCIApressing,thetimesofadditionalmedicationandtheincidenceofpulmonarycomplicationsintheobservationgroupwerelowerthanthoseinthecontrolgroup(p005).Therewasnosignificantdifferenceinanesthesia-relatedsideeffectsbetweenthetwogroups(p0.05).Conclusion：Intercostalnerveblockcombinedwithultrasound-guidedanteriorserra