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《探討超聲引導下椎旁神經(jīng)阻滯在老年患者開胸手術術中及術后的鎮(zhèn)痛效果》由會員上傳分享，免費在線閱讀，更多相關內容在學術論文-天天文庫。
1、探討超聲引導下椎旁神經(jīng)阻滯在老年患者開胸手術術中及術后的鎮(zhèn)痛效果麥偉良黃堅張敏森陳劍波黃曉華【摘要】目的研究超聲引導K椎旁祌經(jīng)阻滯在老年患者開胸手術術屮及術后的鎮(zhèn)痛效果。方法以我院2013年10月-2015年10月收治的40例胸手術患者為研究對象，隨機平分為基本資料無統(tǒng)計學差異的觀察組和對照組，各20例。對照組采用全身麻醉，術屮采用丙泊酚、芬太尼、苯磺順阿曲庫銨等行靜脈注射，以維持麻醉深度。術后單純采用靜脈自控鎮(zhèn)痛(PCIA)鎮(zhèn)痛；觀察組采用超聲引導卜行胸椎旁神經(jīng)阻滯復合PCIA鎮(zhèn)痛，超聲引導卜椎旁神經(jīng)阻滯完成后行全身麻醉及術后PCIA鎮(zhèn)痛，操作與對照組相
2、同。對比兩組的術屮及術后48h內PCIA用藥量，術后2、4、6、8、24、48h的疼痛評分以及并發(fā)癥情況。結果觀察組的用藥量、術后各時段的疼痛評分以及并發(fā)癥總發(fā)生率均顯著低于對照組，差異均具有統(tǒng)計學意義(P<0.05)o結論在老年患者開胸手術屮采用超聲引導丁椎旁神經(jīng)阻滯的方式，能有效減少患者的術屮及術后48h內PCIA用藥量，且術屮及術后的鎮(zhèn)痛效果提高，總并發(fā)癥的發(fā)生率降低，是對老年患者安全有效方式?！娟P鍵字】老年患者；超聲引導；椎旁神經(jīng)阻滯；開胸手術；鎮(zhèn)痛效果Underultrasoundguidedbythevertebralnerveblock
3、openchestsurgeryinelderlypatientswithintraoperativeandpostoperativeanalgesiaeffectMaiWei?liang,,HuangJian,ZhangMin?sen,ChenJianbo,HuangXiaohua.DepartmentofAnesthesiology,YunfuPeople'sHospital,Yunfu527300,China[Abstract]objectivetostudytheultrasoundguidedbythevertebralnerveblockope
4、nchestsurgeryinelderlypatientswithintraoperativeandpostoperativeanalgesiaeffect.MethodsourhospitalinOctober2013andOctober2013-40casesofthoracicsurgerypatientsastheresearchobject,andrandomlydivideasthebasicdataofnostatisticaldifferencesbetweentheobservationgroupandcontrolgroup,20ca
5、seseach.Thecontrolgroupwithgeneralanesthesia,intraoperativeuseofpropofol,fentanylandbenzenesulfonicshunatracuriumintravenousline,inordertomaintainanesthesiadepth.Onlywithpostoperativeintravenousself-controlanalgesia(PCIA);ObservationgroupadoptscompositePCIAanalgesiabydescendingtho
6、racicnerveblockguidedbyultrasound,ultrasoundguidedbythevertebralnerveblockcompletedaftergeneralanesthesiaandpostoperativePCIAanalgesia,operationisthesameasthecontrolgroup.Comparedtotwogroupswithin48hofintraoperativeandpostoperativePCIAdose,2,4,6,8,24and48hpainscoreandcomplications
7、.Resultsobservationgroupdoseineachperiod,postoperativepainscoreandthetotalincidenceofcomplicationsweresignificantlylowerthanthecontrolgroup,thedifferenceswerestatisticallysignificant(P<0.05).Conclusionopenheartsurgeryinelderlypatientswithultrasonicguidedbythevertebralnerveblock
8、intheway,caneffectivelyreducethen
