罗哌卡因肋间神经阻滞对肺癌患者胸腔镜术后镇痛效果的影响

李跃; 宫立群; 徐锋; 赵洪伟; 陈玉龙; 王长利

doi:10.3969/j.issn.1000-8179.2017.12.205

罗哌卡因肋间神经阻滞对肺癌患者胸腔镜术后镇痛效果的影响

doi: 10.3969/j.issn.1000-8179.2017.12.205

李跃^①,,
宫立群^①, ,,
徐锋^①,
赵洪伟^②,
陈玉龙^①,
王长利^①

①.
天津医科大学肿瘤医院肺部肿瘤科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室，天津市恶性肿瘤临床医学研究中心（天津市300060）
②.
天津医科大学肿瘤医院肺部麻醉科，国家肿瘤临床医学研究中心，天津市肿瘤防治重点实验室，天津市恶性肿瘤临床医学研究中心（天津市300060）

详细信息

作者简介:
李跃专业方向为肺癌诊断与微创手术治疗。E-mail：liyuetcih@163.com

通讯作者:
宫立群 gongliqun@tjmuch.com

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出版历程
- 收稿日期: 2017-02-02
- 修回日期: 2017-05-04
- 刊出日期: 2017-06-30

Effects of ropivacaine as intercostal nerve blocker on postoperative pain after video-assisted thoracic surgery of lung cancer patients

Yue LI^{①
,},
Liqun GONG^{①
, ,},
Feng XU^①,
Hongwei ZHAO^②,
Yulong CHEN^①,
Changli WANG^①

①.
Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital; National Clinical
②.
Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital; National Clinical,Tianjin 300060, China

More Information

Corresponding author: Liqun GONG; E-mail: gongliqun@tjmuch.com

摘要

摘要: 目的探讨罗哌卡因肋间神经阻滞对肺癌患者胸腔镜术后镇痛效果的影响。方法分析2016年10月至2016年12月天津医科大学肿瘤医院60例接受肺癌胸腔镜手术治疗的患者，男性35例，女性25例，随机分为2组，分别为0.25%罗哌卡因阻滞组（试验组）和对照组，关胸前行肋间神经阻滞，每一肋间给药3 mL，拔出气管插管后行PCIA镇痛。记录拔管后12 h（T1）、24 h（T2）、48 h（T3）、72 h（T4）时试验组及对照组静息时疼痛VAS评分及Prince-Henry（P-H）评分；以及术后吗啡追加剂量和不良反应事件。结果试验组术后T1~T4各时间点VAS和P-H评分均低于对照组（P＜0.01）。术后试验组咳嗽费力、肺部感染、肺不张等呼吸系统并发症发生率较低（P＜0.05）。结论罗哌卡因肋间神经阻滞可有效减轻肺癌术后患者疼痛并降低术后呼吸系统并发症。
- 罗哌卡因 /
- 肋间神经阻滞 /
- 肺癌 /
- 镇痛
Abstract: Objective To investigate the effects of ropivacaine as intercostal nerve blocker on postoperative pain after video-assistedthoracic surgery(VATS)of lung were cancer patients. Methods A total of 60 patients who underwent elective VATS were randomly divided into two groups.The patients in control group were ereated with intercostal nerve blocker with saline.The patients in test groupwere administrated with intercostal nerve blocker with 0.25% ropivacaine.The effects were evaluated using the visual analogue scale(VAS)and Prince Henry Pain Scale(PHPS)at 12(T1), 24(T2), 48(T3), and 72 h(T4) after extubation.Moreover, the adverse events anddosage of morphine after surgery were measured. Results Compared with the control group, the VAS and PHPS scores of the testgroup were significantly low at T1-T4(P < 0.01).Postoperative respiratory complications, such as pulmonary infection and atelectasis, were less in the test group(P < 0.05) than control. Conclusion Intercostal nerve block with ropivacaine provides good analgesic effectsfor patients underwent VATS.
- ropivacaine /
- intercostal nerve block /
- lung cancer /
- analgesia

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图 1 胸腔镜术中行细针穿刺罗哌卡因肋间神经阻滞

Figure 1. Ropivacaine intercostal nerve block for VATS with fine-needle aspiration

下载: 全尺寸图片幻灯片

表 1 患者不同时间点VAS评分及PHPS评分的比较

Table 1. Comparison of VAS and PHPS scales between the test and control groups

表 2 患者术后带管时间及吗啡用量的比较

Table 2. Comparison of the dosage of morphine and the time of intubation between test group and control group

表 3 患者术后咳嗽及感染情况的比较

Table 3. Comparison of cough and infection in test and control group

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