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超声引导下前锯肌和竖脊肌平面阻滞在微创肺癌根治术中的应用价值
引用本文:潘忠,王道猛,顾向森,钱斌. 超声引导下前锯肌和竖脊肌平面阻滞在微创肺癌根治术中的应用价值[J]. 岭南现代临床外科, 2020, 20(5): 624-627. DOI: 10.3969/j.issn.1009-976X.2020.05.017
作者姓名:潘忠  王道猛  顾向森  钱斌
作者单位:扬州市江都人民医院胸外科,江苏扬州 225200
基金项目:扬州市"科教强卫工程"创新团队;扬州市"科教强卫工程"资助项目
摘    要:目的 探讨超声引导下前锯肌和竖脊肌平面阻滞在微创肺癌根治术快速康复中的应用价值。方法 回顾性分析2017年5月至2019年11月扬州市江都人民医院收治的120例行微创肺癌根治术患者的临床资料。按照术中麻醉和术后镇痛方案的不同随机分为两组,每组60例。A组为对照组,麻醉方式为全麻插双腔管,镇痛方式为静脉自控镇痛泵镇痛;B组为观察组,麻醉方式为全麻双腔气管插管,镇痛方式为超声引导下前锯肌、竖脊肌平面阻滞+静脉自控镇痛泵镇痛。观察两组患者术中指标、术后镇痛效果及临床相关指标。结果 120例患者均顺利完成手术。两组患者术中心率。血压、血氧饱和度等指标比较无统计学差异(P>0.05),两组患者术后疼痛评分、术后头昏发生率、术后恶心呕吐发生率、术后肺部感染发生率、术后下床活动时间等指标比较差异有统计意义(P<0.05)。结论 超声引导下前锯肌和竖脊肌平面阻滞具有良好的镇痛效果,可以达到术后快速康复的目的。

关 键 词:微创  神经阻滞  肺癌  快速康复  
收稿时间:2020-07-20

Application value of ultrasound-guided anterior serratus and erector spinae block in surgery of minimally invasive lobectomy
WANG Dao-meng,GU Xiang-sen,PAN Zhong,QIAN Bin. Application value of ultrasound-guided anterior serratus and erector spinae block in surgery of minimally invasive lobectomy[J]. Lingnan Modern Clinics in Surgery, 2020, 20(5): 624-627. DOI: 10.3969/j.issn.1009-976X.2020.05.017
Authors:WANG Dao-meng  GU Xiang-sen  PAN Zhong  QIAN Bin
Affiliation:Department of Thoracic Surgery, Jiangdu People's Hospital of Yangzhou, JiangSu Yangzhou 225200, China
Abstract:Objective To explore the value of ultrasound-guided anterior serratus and erector spinae block in the rapid rehabilitation of minimally invasive lung cancer radical surgery. Methods Retrospective data were analyzed in 120 patients with minimally invasive radical resection of lung cance in Jiangdu People's Hospital from May 2017 to November 2019. According to the different anaesthetic and postoperative analgesia program, the patients were randomized into two groups, 60 cases in each group. The anaesthetic mode of control group was double lumen endotracheal catheter intubation and analgesic method was in the form of patient-controlled intravenous analgesia pump. The anaesthetic mode of observation group was double lumen endotracheal catheter intubation and analgesic method was ultrasound-guided serratus anterior muscle and erector spinae plane block + intravenous self-controlled analgesic pump analgesia. The intraoperative index, postoperative analgesic effect and clinical related index were observed in two groups of patients. Results All 120 patients successfully completed the operation. There was no significant difference in heart rate, blood pressure and oxygen saturation during operation between the two groups (P>0.05). There were statistically significant differences in postoperative pain score, incidence of postoperative dizziness, postoperative nausea and vomiting, incidence of postoperative pulmonary infection and postoperative ambulation time between the two groups (P<0.05). Conclusion Ultrasound-guided serratus anterior muscle and erector spinae plane block has good analgesic effect, can achieve the goal of rapid recovery after surgery.
Keywords:lung cancer  minimally invasive  nerve block  rapid recovery  
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