[肿瘤外科实践中用于预防慢性开胸术后疼痛综合征的区域和外周阻滞]
[Regional and peripheral blockades for prevention of chronic post-thoracotomy pain syndrome in oncosurgical practice].
作者信息
Khoronenko V E, Malanova A S, Baskakov D S, Ryabov A B, Pikin O V
机构信息
Herzen Moscow Research Oncology Institute, the branch of National Medical Research Radiological Center, Ministry of Health of Russia, Moscow, Rusia.
出版信息
Khirurgiia (Mosk). 2017(8):58-63. doi: 10.17116/hirurgia2017858-63.
AIM
To compare an effectiveness of thoracic epidural anesthesia/analgesia, paravertebral and intercostal blockades in prevention of chronic post-thoracotomy pain syndrome (CPTPS) in oncosurgery.
MATERIAL AND METHODS
There were 300 patients who underwent open surgery including lobectomy or pneumonectomy. Patients were randomized into 3 groups depending on type of anesthesia: TEA (n=100) - combined general and epidural anesthesia; PVB (n=50) - combined general and paravertebral anesthesia; ICB (n=50) - general anesthesia was supplemented by intercostal blockade after removal of the drug.
RESULTS
CPTPS incidence was 34 and 40% in 6 months postoperatively after PVB and ICB, respectively (p>0.05). In TEA group this value was significantly lower compared with ICB group (23%, p<0.05).
CONCLUSION
TEA contributes to significant reduction of CPTPS incidence, while paravertebral blockade does not affect the frequency of this complication.
目的
比较胸段硬膜外麻醉/镇痛、椎旁阻滞和肋间阻滞在肿瘤手术中预防开胸术后慢性疼痛综合征（CPTPS）的效果。
材料与方法
300例行开胸手术（包括肺叶切除术或全肺切除术）的患者，根据麻醉类型随机分为3组：TEA组（n = 100）——全身麻醉联合硬膜外麻醉；PVB组（n = 50）——全身麻醉联合椎旁麻醉；ICB组（n = 50）——全身麻醉并在拔管后行肋间阻滞。
结果
PVB组和ICB组术后6个月CPTPS发生率分别为34%和40%（p>0.05）。TEA组该值显著低于ICB组（23%，p<0.05）。
结论
胸段硬膜外麻醉有助于显著降低CPTPS发生率，而椎旁阻滞不影响该并发症的发生频率。
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