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超声引导联合全身麻醉对高龄肺癌肺叶切除术患者的术中镇痛效果及术后早期转归的影响
引用本文:周瑜,代俊超,毕小波. 超声引导联合全身麻醉对高龄肺癌肺叶切除术患者的术中镇痛效果及术后早期转归的影响[J]. 中国肿瘤临床, 2021, 48(4): 174-179. DOI: 10.3969/j.issn.1000-8179.2021.04.076
作者姓名:周瑜  代俊超  毕小波
作者单位:西南医科大学附属医院麻醉科(四川省泸州市646000)
摘    要:目的:探讨超声引导竖脊肌平面阻滞联合全身麻醉对75岁以上高龄肺癌肺叶切除术患者术中镇痛效果及术后早期转归的影响.方法:分析2018年6月至2019年6月西南医科大学附属医院收治的75岁以上高龄肺癌患者63例,均拟行肺叶切除术,按照随机数字表法分为对照组31例、观察组32例.对照组采用全身麻醉,观察组采用超声引导竖脊肌平...

关 键 词:超声引导竖脊肌平面阻滞  全身麻醉  高龄  肺癌  肺叶切除术  镇痛
收稿时间:2020-11-12

Effect of ultrasound-guided erector spinae plane block combined with general anesthesia on intraoperative analgesia and early postoperative outcomes in patients undergoing lobectomy for lung cancer
Yu Zhou,Junchao Dai,Xiaobo Bi. Effect of ultrasound-guided erector spinae plane block combined with general anesthesia on intraoperative analgesia and early postoperative outcomes in patients undergoing lobectomy for lung cancer[J]. Chinese Journal of Clinical Oncology, 2021, 48(4): 174-179. DOI: 10.3969/j.issn.1000-8179.2021.04.076
Authors:Yu Zhou  Junchao Dai  Xiaobo Bi
Affiliation:Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
Abstract:Objective:To investigate the effect of ultrasound-guided erector spinae plane block combined with general anesthesia on intraoperative analgesia and early postoperative outcomes in patients aged over 75 years undergoing lobectomy for lung cancer.Methods:In this study,we enrolled 63 patients with advanced lung cancer aged 75 years and older who were admitted to The Affiliated Hospital of Southwest Medical University between June 2018 and June 2019.All patients underwent lobectomy.Using the random number table method,patients were assigned into the control group(31 cases)and the observation group(32 cases).The control group received general anesthesia,while the observation group received ultrasound-guided erector spinae plane block in combination with general anesthesia.Operation-related indexes,postoperative recovery time,postoperative duration of hospitalization,changes in mean arterial pressure and heart rate at different time points during the operation,dosage of remifentanil during the operation,postoperative vital capacity,postoperative analgesic effects,postoperative rehabilitation quality,postoperative cognitive function,and adverse reactions were compared between the two groups.Results:There was no significant difference in operative time,anesthesia time,postoperative recovery time,or postoperative duration of hospitalization between the two groups(P>0.05).The mean arterial pressure and heart rate in the observation group were lower than those in the control group(P<0.05)during intubation,skin cutting,and extubation;the vital capacities at 12 h,24 h,and 48 h after the operation were higher in the observation group than in the control group(P<0.05);the remediation rate of postoperative analgesia,number of compressions of the analgesia pump,total infusion volume,the visual analog scale scores at 6 h,12 h,and 72 h post-operation in the observation group were lower than those in the control group(P<0.05);the scores for rehabilitation quality at 24 h,48 h,and 72 h post-operation in the observation group were higher than those in the control group(P<0.05).The incidence of cognitive dysfunction at 6 h,12 h,and 24 h post-operation in the observation group was lower than that in the control group(P<0.05).The overall incidence of adverse reactions was 37.50%and 70.97%in the observation and control groups,respectively(P<0.05).Conclusions:Ultrasound-guided erector spinae plane block combined with general anesthesia is effective for patients over 75 years of age undergoing lobectomy for lung cancer.The intraoperative analgesia is relatively stable.Furthermore,the patients'vital signs during operation are relatively stable,and the postoperative recovery of lung function is rapid.Other advantages of this approach include good quality of rehabilitation,low rate of postoperative analgesic remediation,an accurate anesthetic effect,low risk,and safety.In addition,patients only experience mild pain,have a low incidence of postoperative cognitive dysfunction,and have fewer adverse reactions.Therefore,it is worth promoting this approach.
Keywords:ultrasound-guided erector spinae plane block  general anesthesia  advanced age  lung cancer  lobectomy  analgesia
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