竖脊肌平面阻滞联合全身麻醉在胸腔镜肺癌根治术中麻醉镇痛效果观察

目的探析竖脊肌平面阻滞(ESPB)联合全身麻醉在胸腔镜肺癌根治术中麻醉镇痛效果观察。方法以2018年10月至2019年10月经本院收治且确立可行胸腔镜肺癌根治术78例肺癌患者开展研究,遵照随机数字表法,分设对照组和观察组,予以对照组全身麻醉,观察组则施以ESPB联合全身麻醉,术后均行静脉自控镇痛(PCIA)作镇痛补救,比较两组临床指标、血流动力学水平、麻醉镇痛效果及并发症及不良反应状况。结果两组手术时间比较无统计学意义(P>0.05),观察组拔管时间、住院时间均较对照组更短(P<0.05);两组T₁、T₂、T₃时MAP、HR水平波动幅度呈先上升后下降趋势(P<0.05),且在T₂时,观察组MAP、HR水平与对照组比较更高(P<0.05);观察组术中丙泊酚、瑞芬太尼维持剂量及术后PCIA使用次数均较对照组更低(P<0.05);两组T₄、T₅、T₆时静息或运动VAS评分变化幅值呈先上升后下降趋势(P<0.05),且于T₄、T₅、T₆时,观察组静息或运动VAS评分较对照组更低(P<0.05);两组均未出现气胸、硬膜外损伤及心动过速等严重并发症,而不良反应状况中,观察组不良反应总发生率为10.26%,相较于对照组(38.46%)更低(P<0.05)。结论行胸腔镜肺癌根治术患者采用ESPB联合全身麻醉,拔管时间提前,住院时长有所缩短,血流动力学表现平稳,具有良好麻醉镇痛效果,不良反应较为轻微。

Observation on Anesthesia Analgesia Effect of Erector Spinae Plane Block Combined with General Anesthesia During Thoracoscopic Radical Resection of Lung Cancer

Objective To explore and analyze the anesthesia analgesia effect of erector spinae plane block(ESPB)combined with general anesthesia during thoracoscopic radical resection of lung cancer.Methods A study was carried out on 78 patients with lung cancer who were admitted to this hospital from October 2018 to October 2019 and confirmed feasible thoracoscopic radical resection of lung cancer.According to the random number table method,the control group,and the observation group were set.The control group was given general anesthesia while the observation group was performed ESPB combined with general anesthesia,and both groups underwent patient controlled intravenous analgesia(PCIA)as analgesic remedy after surgery.The clinical indicators,hemodynamic level,anesthesia analgesia effect,complications and adverse reactions were compared between the two groups.Results There was no statistically significant difference in surgical time between the two groups(P>0.05).The extubation time and hospital stay in the observation group were shorter than those in the control group(P<0.05).The fluctuation ranges of MAP and HR in the two groups at T₁,T₂,and T₃ were increased first and then decreased(P<0.05),and at T₂,the levels of MAP and HR in the observation group were higher than those in the control group(P<0.05).The maintenance doses of propofol and remifentanil during surgery and the frequency of PCIA after surgery were lower in the observation group than those in the control group(P<0.05).The changes of resting or exercise VAS scores status at T₄,T₅,and T₆ in the two groups were first increased and then decreased(P<0.05).At T₄,T₅,and T₆,the resting or exercise VAS scores of the observation group were lower than those of the control group(P<0.05).There were no serious complications such as pneumothorax,epidural injury and tachycardia in the two groups.Among the adverse reactions,the total incidence rate of adverse reactions in the observation group was lower than that in control group(10.26%vs.38.46%)(P<0.05).Conclusion ESPB combined with general anesthesia for patients undergoing thoracoscopic radical resection of lung cancer can shorten the extubation time and hospital stay,and can have stable hemodynamic performance,good anesthesia analgesia effect and relatively minor adverse reactions.