| 摘要: |
| ［摘要］ 目的 探讨连续胸椎旁神经阻滞联合右美托咪定静脉镇痛在老年乳腺癌手术麻醉中的应用价值。方法 选取2016-01～2017-12在该院就诊并接受外科手术治疗的老年乳腺癌患者96例，采用随机数字表法将其分为观察组（48例）和对照组（48例）。对照组采用局部浸润及静脉镇痛法麻醉，观察组采用超声引导下连续胸椎旁神经阻滞联合右美托咪定静脉镇痛法麻醉。比较两组术中一般指标、麻醉效果及术后恢复情况。结果 两组年龄、体重、手术用时、术中出血量及补液量比较差异无统计学意义(P>0.05)，但观察组丙泊酚、瑞芬太尼用量显著少于对照组(P<0.05)；两组患者不同时点普通血流动力学CVP水平比较差异无统计学意义(P>0.05)，但T2、T3、T4时点时观察组MAP、HR水平显著低于对照组(P<0.05)；两组患者精确血流动力学指标比较差异均无统计学意义（P>0.05）；术后2 h、6 h、12 h时观察组静息VAS、活动VAS以及Ramsay镇静评分均显著优于对照组(P<0.05)。术后观察组不良反应、并发症发生率显著低于对照组(P<0.05)。结论 老年乳腺癌外科手术麻醉应用连续胸椎旁神经阻滞联合右美托咪定静脉镇痛可提升术中麻醉效果，使患者术中血流动力学指标及循环系统保持稳定。 |
| 关键词: 连续胸椎旁神经阻滞 右美托咪定 血流动力学指标 老年乳腺癌 麻醉效果 |
| DOI：10.3969/j.issn.1674-3806.2019.07.10 |
| 分类号:R 614.2+7 |
| 基金项目:牡丹江市科学技术计划项目（编号：Z2017s0038） |
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| Application value of continuous thoracic paravertebral nerve block combined with dexmedetomidine intraveous analgesia in surgical anesthesia for elderly patients with breast cancer |
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JIN Lian-jin, LI Li, ZHANG Li, et al.
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Department of Anesthesiology, Hongqi Hospital Affiliated to Mudanjiang Medical College, Heilongjiang 157011, China
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| Abstract: |
| ［Abstract］ Objective To investigate the application value of continuous thoracic paravertebral nerve block combined with dexmedetomidine intraveous analgesia in surgical anesthesia for elderly patients with breast cancer. Methods Ninety-six elderly breast cancer patients who were treated with surgery in our hospital from January 2016 to December 2017 were selected. The patients were randomly divided into observation group(n=48) and control group(n=48). The control group was anesthetized by local infiltration and intravenous analgesia, and the observation group was anesthetized by ultrasound-guide continuous paravertebral nerve block combined with dexmedetomidine intravenous analgesia. The general indexes, anaesthesia effect and postoperative recovery were compared between the two groups. Results There were no significant differences in age, weight, operation time, intraoperative bleeding volume and fluid infusion volume between the two groups(P>0.05), but the dosages of propofol and remifentanil in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference in CVP level of general hemodynamics between the two groups at different time phases(P>0.05), but the MAP and HR level at T2, T3 and T4 phases in the observation group were significantly lower than those in the control group(P<0.05), and there were no significant differences in precise hemodynamic indexes(P>0.05). The resting VAS, active VAS and Ramsay Sedation Scores at 2 h, 6 h and 12 h after operation in the observation group were significantly better than those in the control group(P<0.05). The incidence rates of postoperative adverse reactions and complications in the observation group were significantly lower than those in the control group(P<0.05). Conclusion The application of continuous thoracic paravertebral nerve block combined with dexmedetomidine in surgery for elderly patients with breast cancer can improve the anesthetic effect during operation and keep the hemodynamics and circulatory system of the patients stable during operation. |
| Key words: Continuous thoracic paravertebral nerve block Dexmedetomidine Hemodynamic index Senile breast cancer Anesthetic effect |
