肋间神经阻滞联合舒芬太尼鼻黏膜给药用于胸腔镜术后镇痛的临床观察

摘要

Objective: To explore the effects of intercostal nerve block combined with sufentanil intranasal administration on postoperative analgesia of VATS.Methods:60 cases VATS patients were randomly divided into 2 groups: the patients in A group used PCIA, the patients in B group used intercostal nerve block combined with sufentanil intranasal administration. The VAS score of 6h, 12h, 24h, 48h after VATS at rest and activity state of patients in 2 groups were respectively recorded; as well as incidence of complications and satisfaction of patients. Results:The VAS score at rest state of patients in A group at each time point was no statistical signiifcance compared with patients in B group (P>0.05). In 24h (include 24h) after operation, the VAS score at activity state of patients in B group was obviously lower than patients in A group (P<0.05); 24h after operation, the VAS score at activity state of patients in B group was no statistical signiifcance compared with patients in A group (P>0.05). The incidence of complications of patients in B group was obviously lower than A group, but satisfaction was obviously higher (P<0.05). Conclusions:Intercostal nerve block combined with sufentanil intranasal administration can provide satisfactory analgesia in 24 hours, and the complication rate is low, the satisfaction of patients is high.%目的：：探讨肋间神经阻滞联合舒芬太尼鼻黏膜给药对胸腔镜患者术后镇痛效果的影响。方法：60例胸腔镜手术患者随机分为两组，A组采用静脉自控镇痛（PCIA），B组采用肋间神经阻滞联合舒芬太尼鼻黏膜给药。观察记录患者术后6h、12h、24h、48h静息状态和活动状态时的VAS评分，记录两组患者镇痛满意度和并发症情况。结果：两组患者术后各时间点静息时VAS评分比较，差异无统计学意义（P＞0.05）；术后24h内（包括24h），B组活动时VAS评分明显低于A组(P＜0.05)，24h后两组活动状态时VAS评分比较差异无统计学意义（P＞0.05）。B组患者术后并发症发生率明显低于A组、满意度明显高于A组(P＜0.05)。结论：肋间神经阻滞联合舒芬太尼鼻黏膜给药可在24h内提供满意的镇痛效果，且并发症发生率低、患者满意度高。