南方医科大学学报2017，Vol.37Issue(4)：460-464,5.DOI:10.3969/j.issn.1673-4254.2017.04.06
胸椎旁神经阻滞在胸腔镜肺叶切除术中的应用:随机对照试验
Application of thoracic paravertebral nerve block in video-assisted thoracosopic surgery:a randomized controlled trial
摘要
Abstract
Objective To investigate the effect of a single dose of ropivacaine combined with sufentanilfor thoracic paravertebral block (TPVB) on pain and enhanced recovery after surgery (ERAS) in patients undergoing video-assisted thoracosopic surgery. Methods Sixty patients undergoing video-assisted thoracosopic surgery were randomly divided into three groups to receive intravenous combined general anesthesia (group C), a single dose of ropivacainefor thoracic paravertebral block before surgery combined with intravenous and general anesthesia(group T1), or a single dose of ropivacaineand sufentanilfor thoracic paravertebral blockcombined with intravenous and general anesthesia (group T2). None of the patients used postoperative analgesia pump, and tramadol hydrochoride injection (100 mg) was given in cases with NRS scores>4 after the surgery. The data were recorded including analgesics used for nerve block before the operation, intravenous dosage of sufentanilduring operation, total dose of sufentanilused (intravenous+nerve block), intravenous remifentanil dose during operation, NRS scores at 4, 6, 24, 48 h after the surgery, rescue analgesia in the first postoperative 24 h after surgery, ICU stay and hospital stay after the surgery. Results Compared with those in group C, the intravenous sufentanildose, total sufentanildose, intravenous remifentanildose during operation, NRS scores at 4 and 6, 24 h, and ICU stay and hospital stay after the surgery were significantly decreased in groups T1 and T2 (P<0.05). The total dose of opioids during the operation and NRS scores at 4 and 6 h were significantly lower in group T2 than in group T1 (P<0.05), but the total dose of sufentanil, ICU stay and hospital stay were simialr between the two groups. Conclusion A single dose of ropivacaine combined with sufentanilfor thoracic paravertebral blockbefore surgery can reduce the total dose opioids, produce the optimal analgesic effect, and promote postoperative recovery of the patients.关键词
罗哌卡因/椎旁神经阻滞/胸腔镜手术/快速康复Key words
ropivacaine/thoracic paravertebral block/video-assisted thoracosopic surgery/enhanced recovery after surgery引用本文复制引用
张博,刘丹彦..胸椎旁神经阻滞在胸腔镜肺叶切除术中的应用:随机对照试验[J].南方医科大学学报,2017,37(4):460-464,5.基金项目
卫生部国家临床重点专科建设项目[财设(2011)170号] （2011）
重庆市重点学科项目[渝卫科教(2007)2] （2007）
