赣南医科大学学报2025，Vol.45Issue(2)：167-173,7.DOI:10.3969/j.issn.1001-5779.2025.02.009
超声引导椎旁阻滞联合全身麻醉在后腹腔镜肾上腺肿瘤切除术中的临床效果
The effect of ultrasound-guided paravertebral block combined with general anesthesia in posterior retroperitoneal adrenalectomy
摘要
Abstract
Objective:To investigate the effects of ultrasound-guided paravertebral block combined with general anesthesia on intraoperative and postoperative pain,opioid consumption,and postoperative recovery quality in posterior retroperitoneal adrenalectomy.Methods:Sixty patients scheduled for elective posterior retroperitoneal adrenalectomy between April 2023 and December 2024 were randomly included in the paravertebral block combined with general anesthesia group(combined group)and the general anesthesia alone group(simple group),with 30 cases in each group.In the combined group,a single-shot paravertebral block was performed at the T10 level using 25 mL of 0.375%ropivacaine 20 minutes before anesthesia induction,followed by general anesthesia.In the simple group,a sham block was performed at the same location using a blunt needle 20 minutes before anesthesia induction,followed by general anesthesia.The primary outcome was the visual analog scale(VAS)pain score at rest and during movement at different postoperative time points.Secondary outcomes included intraoperative blood pressure and heart rate at different time points,intraoperative and postoperative opioid consumption within 48 hours,the incidence of postoperative nausea and vomiting(PONV)and other adverse events,as well as the quality of recovery(QoR-15)scores at 24 hours postoperatively.Results:Compared with the simple group,the combined group had significantly reduced VAS pain score within 48 hours after extubation(P＜0.001).The dosage of remifentanil during surgery and the dosage of sufentanil after surgery were reduced in the combined group(P＜0.001).The combined group also exhibited smaller fluctuations in mean arterial pressure and heart rate during skin incision and surgical manipulation(P＜0.01).Additionally,the combined group achieved better QoR-15 scores at 24 hours postoperatively and experienced a lower incidence of postoperative nausea and vomiting(P＜0.05).There was no significant difference in the time of first oral intake between the groups(P＞0.05),but the combined group had earlier times of first drinking and gastrointestinal recovery(P＜0.05).Conclusion:Ultrasound-guided paravertebral block combined with general anesthesia provides effective intraoperative and postoperative analgesia for posterior retroperitoneal adrenalectomy,reducing opioid consumption and improving recovery quality.关键词
椎旁阻滞/后腹腔镜肾上腺切除术/术后恢复质量/超声引导Key words
Paravertebral block/Posterior retroperitoneal adrenalectomy/Postoperative recovery/Ultrasound guidance分类
临床医学引用本文复制引用
王超威,邹平,管俊辉,李国强,易勤国,单热爱,占丽芳..超声引导椎旁阻滞联合全身麻醉在后腹腔镜肾上腺肿瘤切除术中的临床效果[J].赣南医科大学学报,2025,45(2):167-173,7.基金项目
赣州市指导性科技计划项目(GZ2018ZSF097) （GZ2018ZSF097）
赣南医学院教育基金会横向课题(HX202205) （HX202205）
