胸腔镜直视下椎旁阻滞在胸腔镜下肺叶切除术术后镇痛中的应用

Abstract
Figure/Table
References (0)
Related Citation (4)

Download: PDF (744 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To evaluate the analgesic effects of thoracoscopic paravertebral block ,which used videoassisted thoracic for analgesia after thoracoscopic lobectomy. Methods: A total of 80 patients, who were treated by thoracoscopic lobectomy in Putian First Hospital from May to December 2019, and as American Society of anesthesiologists （ASA） class Ⅱ-Ⅲ were enrolled in the study. They were divided into control group and paravertebral block （PVB） group randomly and equally, 40 patients, using a random number table. Patients in control group were given patientcontrolled intravenous analgesia （PCIA） after operation. Patients of PVB group anesthetics were injected into the thoracic 4-5 and 8-9 intercostal at the end of surgery combined with PCIA after operation. Postoperative visual analogue scale （VAS） score, the times pressing analgesia pump button, the satisfactory of analgesia, the needs for rescue analgesia were recorded. In addition, the occurence of nausea, vomiting and dizziness and delirium were recorded after surgery. Results: Compared with control group, the VAS score of PVB group were significantly reduced, the times pressing analgesia pump button were decreased, the needs for rescue analgesia were also dropped, the satisfactory of analgesia were increased. Moreover, the incidence of postoperative nausea, vomiting and dizziness in PVB group were significantly lower than that in control group. Conclusion: Thoracoscopic paravertebral block, using videoassisted thoracic combined with PCIA after surgery can effectively alleviate the postoperative pain of thoracic surgey, reduce the reuse of analegsics and the incidence of postoperative adverse reactions.

Received: 17 May 2021

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	KE Pinhui
	LIN Liangqing
	WU Qinghua
	YU Yaohua

Cite this article:

KE Pinhui,LIN Liangqing,WU Qinghua等.

Application of thoracoscopic paravertebral block in analgesia after thoracoscopic lobectomy

[J]. Journal of Jiangsu University(Medicine Edition), 2021, 31(05): 417-420.

URL:

http://zzs.ujs.edu.cn/xbyxb/EN/ OR http://zzs.ujs.edu.cn/xbyxb/EN/Y2021/V31/I05/417

［1］Alhajj N, Chee CF, Wong TW, et al. Lung cancer: active therapeutic targeting and inhalational nanoproduct design［J］. Expert Opin Drug Deliv, 2018, 15（12）: 1223-1247.

［2］Ettinger DS, Wood DE, Aggarwal C, et al. NCCN guidelines insights: nonsmall cell lung cancer, version 1. 2020［J］. J Natl Compr Canc Netw, 2019, 17（12）: 1464-1472.

［3］谢阳,方志源. 肺叶切除术后两种镇痛方法效果比较［J］. 江苏大学学报（医学版）, 2009, 19（3）: 265-267.

［4］Barbosa FT, Barbosa TR, Cunha RM. Comparison between continuous thoracic epidural and paravertebral blocks for postoperative analgesia in patients undergoing thoracotomy: metaanalysis of clinical trials［J］. Braz J Anesthesiol, 2015, 65（5）: 422-423.

［5］Komatsu T, Sowa T, Takahashi K, et al. Paravertebral block as a promising analgesic modality for managing postthoracotomy pain［J］. Ann Thorac Cardiovasc Surg, 2014, 20（2）: 113-116.

［6］高蓉, 卞清明.PCVVG联合PEEP对胸腔镜下行肺癌根治术患者的肺保护作用［J］. 江苏大学学报（医学版）, 2020, 30（1）: 68-71.

［7］李雪娇,许庆珍,肖洪玲,等. 胸腔镜与开胸肺叶切除术后患者慢性疼痛的对比研究［J］. 临床肺科杂志,2016,21（8）:1372-1374.

［8］Sengupta S. Postoperative pulmonary complications after thoracotomy［J］. Indian J Anaesth, 2015, 59（9）: 618-626.

［9］Dizdarevic A, Fernandes A. Thoracic paravertebral block, multimodal analgesia, and monitored anesthesia care for breast cancer surgery in primary lateral sclerosis［J］. Case Rep Anesthesiol, 2016, 2016: 6301358.

［10］周桥灵, 刘洪珍, 伍辉萍, 等. 超声引导下竖脊肌平面阻滞联合静脉镇痛用于肝叶切除术患者的效果［J］. 临床麻醉学杂志, 2019, 35（7）: 635-639.

［11］Esper SA, HolderMurray J, Subramaniam K, et al. Enhanced recovery protocols reduce mortality across eight surgical specialties at academic and universityaffiliated community hospitals［J］. Ann Surg, 2020.doi: 10.1097/SLA.0000000000004642.［Epub ahead of print］

［12］宋金玲, 孙立新, 王明山. 椎旁神经阻滞或硬膜外阻滞复合全麻对开胸手术炎性反应的影响［J］. 临床麻醉学杂志, 2013, 29（5）: 472-474.

［13］祁羽鹏, 马文静, 杨光, 等. 腹部非胃肠道手术患者术后恶心呕吐的发生情况及影响因素分析［J］. 山东医药, 2020, 60（27）: 66-68.