超声引导下颈部迷走神经阻滞联合胸椎旁阻滞在胸腔镜手术中的应用

R614.2; 目的·评估超声引导下颈部迷走神经阻滞(cervical vagal block,CVB)联合胸椎旁阻滞(thoracic paravertebral block,TPVB)在胸腔镜肺大疱切除术中的安全性和有效性.方法·纳入2019年1月—2020年2月于上海交通大学附属第六人民医院东院择期行胸腔镜下肺大疱切除术患者40例,采用随机数字表将其分为双腔支气管插管全身麻醉(general anaesthesia with double lumen tube,GA+DLT)组20例,以及非气管插管神经阻滞麻醉(non-intubated nerve block anaesthesia,...

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Published in上海交通大学学报（医学版） Vol. 41; no. 1; pp. 66 - 69
Main Authors 程晨, 范坤, 张瑛
Format Journal Article
LanguageChinese
Published 上海交通大学附属第六人民医院麻醉科,上海 200233 28.01.2021
Subjects
迷走神经阻滞
肺大疱切除术
胸腔镜
超声引导
胸椎旁阻滞
Online AccessGet full text
ISSN1674-8115
DOI10.3969/j.issn.1674-8115.2021.01.011

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Abstract R614.2; 目的·评估超声引导下颈部迷走神经阻滞(cervical vagal block,CVB)联合胸椎旁阻滞(thoracic paravertebral block,TPVB)在胸腔镜肺大疱切除术中的安全性和有效性.方法·纳入2019年1月—2020年2月于上海交通大学附属第六人民医院东院择期行胸腔镜下肺大疱切除术患者40例,采用随机数字表将其分为双腔支气管插管全身麻醉(general anaesthesia with double lumen tube,GA+DLT)组20例,以及非气管插管神经阻滞麻醉(non-intubated nerve block anaesthesia,NINBA)组20例.GA+DLT组采用支气管插管静吸复合全身麻醉,术后采用患者静脉自控镇痛(patient controlled intravenous analgesia,PCIA).NINBA组行超声引导下CVB联合TPVB,予0.5％罗哌卡因40 mL.记录2组患者术中是否出现呛咳、出血量、低氧血症发生情况和手术时间,术后胸闷发生情况、运动视觉模拟评分(visual analogue score,VAS)、恶心呕吐发生率、术后帕瑞昔布钠使用次数、术后住院天数及Bruggermann舒适评分(Bruggermann Comfort Score,BCS).用SPSS 19.0软件进行统计学分析,定量资料以-x±s表示,组间比较采用t检验;定性资料采用χ2检验.结果·2组患者术中均未出现低氧血症和呛咳,出血量和手术时间差异无统计学意义.NINBA组患者术后运动VAS较GA+DLT组低(P=0.008),术后帕瑞昔布钠使用次数较GA+DLT组少(P=0.000);NINBA组患者BCS较GA+DLT组明显升高(P=0.020);与NINBA组比较,GA+DLT组患者术后恶心呕吐发生率高.结论·超声引导下CVB联合TPVB可安全、有效地用于胸腔镜下肺大疱切除术.
AbstractList R614.2; 目的·评估超声引导下颈部迷走神经阻滞(cervical vagal block,CVB)联合胸椎旁阻滞(thoracic paravertebral block,TPVB)在胸腔镜肺大疱切除术中的安全性和有效性.方法·纳入2019年1月—2020年2月于上海交通大学附属第六人民医院东院择期行胸腔镜下肺大疱切除术患者40例,采用随机数字表将其分为双腔支气管插管全身麻醉(general anaesthesia with double lumen tube,GA+DLT)组20例,以及非气管插管神经阻滞麻醉(non-intubated nerve block anaesthesia,NINBA)组20例.GA+DLT组采用支气管插管静吸复合全身麻醉,术后采用患者静脉自控镇痛(patient controlled intravenous analgesia,PCIA).NINBA组行超声引导下CVB联合TPVB,予0.5％罗哌卡因40 mL.记录2组患者术中是否出现呛咳、出血量、低氧血症发生情况和手术时间,术后胸闷发生情况、运动视觉模拟评分(visual analogue score,VAS)、恶心呕吐发生率、术后帕瑞昔布钠使用次数、术后住院天数及Bruggermann舒适评分(Bruggermann Comfort Score,BCS).用SPSS 19.0软件进行统计学分析,定量资料以-x±s表示,组间比较采用t检验;定性资料采用χ2检验.结果·2组患者术中均未出现低氧血症和呛咳,出血量和手术时间差异无统计学意义.NINBA组患者术后运动VAS较GA+DLT组低(P=0.008),术后帕瑞昔布钠使用次数较GA+DLT组少(P=0.000);NINBA组患者BCS较GA+DLT组明显升高(P=0.020);与NINBA组比较,GA+DLT组患者术后恶心呕吐发生率高.结论·超声引导下CVB联合TPVB可安全、有效地用于胸腔镜下肺大疱切除术.
Author 张瑛
范坤
程晨
AuthorAffiliation 上海交通大学附属第六人民医院麻醉科,上海 200233
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FAN Kun
CHENG Chen
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Keywords 迷走神经阻滞
肺大疱切除术
胸腔镜
超声引导
胸椎旁阻滞
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Title 超声引导下颈部迷走神经阻滞联合胸椎旁阻滞在胸腔镜手术中的应用
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