摘要
目的探究超声引导双侧竖脊肌平面阻滞对开腹肝癌术后镇痛及早期康复效果。方法选取2018年1月~2019年12月本院收治的行开腹肝癌切除术治疗患者140例,根据随机数字表法分为对照组和观察组,各70例,对照组给予常规静脉镇痛,观察组给予超声引导双侧竖脊肌平面阻滞术镇痛,比较分析两组患者的术后疼痛评分、术后恢复时间、额外镇痛药物补救及不良反应情况。结果观察组患者术后4h疼痛评分(5.99±0.75)分、12h疼痛评分(3.78±0.41)分、24h疼痛评分(2.98±0.39)分、48h疼痛评分(2.59±0.31)分明显低于对照组患者的术后4h疼痛评分(6.48±0.87)分、12h疼痛评分(5.89±0.79)分、24h疼痛评分(4.47±0.32)分、48h疼痛评分(3.66±0.45)分(P<0.05)。观察组患者的首次排气时间(31.62±4.20)h、术后下床时间(45.64±5.99)h、住院时间(8.78±0.84)d明显低于对照组患者的首次排气时间(38.56±5.01)h、术后下床时间(64.53±8.42)h、住院时间(10.97±1.01)d(P<0.05)。观察组患者的额外镇痛药物补救率(17.14%)、不良反应发生率(7.15%)明显低于对照组的额外镇痛药物补救率(31.43%)、不良反应发生率(18.57%)(P<0.05)。结论超声引导双侧竖脊肌平面阻滞对开腹肝癌术后镇痛效果显著,促进术后康复,降低镇痛药物补救率,减少不良反应。
Objective To explore the effect of ultrasound-guided bilateral erector spinae plane block(ESPB)on analgesia and early rehabilitation after open hepatectomy for liver cancer.Methods 140 patients admitted to our hospital and treated with open hepatectomy for liver cancer from January 2018 to December 2019 were selected and divided into the control group and the observation group with 70 patients in each group according to random number table method.The control group was given conventional intravenous analgesia,and the observation group was given ultrasound-guided bilateral ESPB for analgesia.The postoperative pain scores,the postoperative recovery time,additional analgesic drug remedies and adverse reactions(ADRs)of the two groups were compared and analyzed.Results The postoperative 4 h pain scores(5.99±0.75),12 h pain scores(3.78±0.41),24 h pain scores(2.98±0.39)and 48 h pain scores(2.59±0.31)of the patients in the observation group were significantly lower than the postoperative 4 h pain scores(6.48±0.87),12 h pain scores(5.89±0.79),24 h pain scores(4.47±0.32)and 48 h pain scores(3.66±0.45)of the patients in the control group(P<0.05).The first exhaust time(31.62±4.20)h,postoperative off-bed time(45.64±5.99)h and hospitalization time(8.78±0.84)h of the patients in the observation group were significantly lower than the first exhaust time(38.56±5.01)h,postoperative off-bed time(64.53±8.42)h and hospitalization time(10.97±1.01)d of the patients in the control group(P<0.05).The remedial rate of additional analgesic drugs(17.14%)and the incidence rate of ADRs(7.15%)of the patients in the observation group were significantly lower than the remedial rate of additional analgesic drugs(31.43%)and the incidence rate of ADRS(18.57%)of the patients in the control group(P<0.05).Conclusion Ultrasound-guided bilateral ESPB has significant efficacy for analgesia after open hepatectomy for liver cancer.It promotes postoperative rehabilitation,lowers the remedial rate of analgesic drugs,and reduces ADRs.
作者
蔡广雄
CAI Guangxiong(Department of Anesthesiology,Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou Worker's Hospital,Guangxi,Liuzhou 545005,China)
出处
《中国医药科学》
2020年第12期95-98,共4页
China Medicine And Pharmacy
关键词
超声引导双侧竖脊肌平面阻滞术
开腹肝癌术
镇痛
早期康复
Ultrasound-guided bilateral erector spinae plane block(ESPB)
Open hepatectomy for liver cancer
Analgesia
Early rehabilitation
