开胸术后持续肋间神经阻滞镇痛技术(附53例分析)

目的　探讨开胸术后一种简单而有效的间歇给药的局部镇痛技术。方法　关胸前于切口后端上、下肋间处通过硬膜外套管针 ,经皮穿刺直视下放置硬膜外导管于切口上、下两根肋骨角下方的肋间神经处 ,术后间断注射局麻药以阻滞支配切口区域的肋间神经。结果　在病人手术结束后全身麻醉消失并开始诉说疼痛时作最初的肋间神经阻滞 ,5 3例中 ,42例 (79.2 %)肋间神经阻滞效果明显 ,术后完全停止肌肉或静脉的镇痛药使用 ;11例不同程度的减少了肌注止痛药的用量或次数。结论　该项技术能长时间保留镇痛管并连续或重复注药 ,镇痛效果好 ,持续时间长 ,简单易行 ,无置管并发症及药物毒副作用。

Continuous intercostal nerve block analgesia following thoracotomy(A report 53 cases)

Objective To seek for a simple,safe,and effective technique for the intermittent administration of regional analgesia.Methods The postoperative production of continuous intercostal nerve blockade can be accomplished by the insertion of indwelling analgesic catheters at the time of thoracotomy closure.To administer the initial nerve block as the patient began to complain of pain.Result There were 42 patients(79.2%)acceptance of the procedure was excellent.There was no complications.Conclusion The technique for continuous intercostal nerve block analgesia is a safe and largely effective means of controlling incisional chest wall pain after thoracotomy.