术前肋间神经阻滞对开胸患者术后早期镇痛效果的影响

目的探讨术前肋间神经阻滞对开胸术后早期镇痛效果的影响。方法择期行开胸肺大泡切除手术患者50例,美国麻醉学医师学会（American Society of Anesthesiologists,ASA）分级Ⅰ-Ⅱ级,随机分为2组：A组（n=25）采用肋间神经阻滞合并皮下自控镇痛;B组（n=25）为单纯使用皮下自控镇痛,两组均于术毕关胸前启动皮下PCA镇痛（patient controlled analgesia,PCA）,分别记录拔管清醒后、术后4 h的VAS疼痛评分,生命体征以及术后镇痛药的使用情况。结果与B组比较,A组在术后早期镇痛的有效率、镇痛药的用量以及术后MAP、HR差异有显著性（P〈0.01）。结论术前行肋间神经阻滞可增强开胸术后早期皮下镇痛效果,减少镇痛药的用量。

The early analgesia effects of intercostal nerve block before operation on post thoracotomy

Objective To investigate the early analgesia effect of intercostal nerve block before operation on post thoracotomy.Methods Fifty patients（ASAⅠ-Ⅱ）,scheduled for selected thoracic surgeries were randomly divided into two groups： intercostal nerve block combined with patient-controlled analgesia（PCA） subcutaneously（group A,n=25）,and sole PCA（group B,n=25）.Both groups used PCSA before closing the thoracic cavity.The ache degree,dose of Tramal and vital signs were compared 4 h after surgery when patients regained senses and tubes were removed.Results The VAS,vital signs including MAP and HR,and dose of drugs in group A were significantly superior to those in group B（P〈0.01）.Conclusion Intercostal nerve block before operation can improve the early analgesic effects of post thoracotomy and reduce the dose of drugs used.