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微创根治性食管癌手术后连续椎旁阻滞的疗效和安全性。

Efficacy and Safety of Continuous Paravertebral Block after Minimally Invasive Radical Esophagectomy for Esophageal Cancer.

机构信息

Department of Thoracic, Affiliated Jining No. 1 People's Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China.

出版信息

Pain Res Manag. 2020 Apr 21;2020:3105874. doi: 10.1155/2020/3105874. eCollection 2020.

Abstract

OBJECTIVE

To compare the effects of continuous paravertebral block analgesia and patient-controlled intravenous analgesia after minimally invasive radical esophagectomy for esophageal cancer and their effects on postoperative recovery.

METHODS

A retrospective analysis was performed among 233 patients who underwent minimally invasive esophageal cancer radical operation and met the requirements, including 87 patients (group C) who were successfully placed with a continuous paravertebral block device under direct vision and 146 patients (group P) who used a patient-controlled intravenous analgesia device. Visual analogue pain score (VAS) at rest and in motion for 1, 3, 6, 12, 24, 36, and 48 hours after awakening, incidence of adverse reactions of the two analgesic methods, occurrence of pulmonary complications after operation, use of emergency analgesics, and hospital stay after operation was recorded.

RESULTS

The VAS scores of group C in resting and active state at 1, 3, 6, 12, 24, 36, and 48 hours after operation were significantly lower than those of group P ( < 0.001). The incidence of adverse reactions, pulmonary complications, and the use of emergency analgesics in group C were lower than those in group P ( < 0.05). The hospitalization time of group C was significantly shortened, and the satisfaction degree of group C was significantly higher than that of group P ( < 0.05).

CONCLUSION

Paravertebral block is safe and effective for patients undergoing minimally invasive radical esophagectomy. The incidence of adverse reactions and complications is lower, and the satisfaction of postoperative analgesia is higher, which is beneficial to the rapid recovery of patients after operation.

摘要

目的

比较微创食管癌根治术后连续椎旁阻滞镇痛与患者自控静脉镇痛的效果及其对术后恢复的影响。

方法

对 233 例行微创食管癌根治术且符合要求的患者进行回顾性分析,包括 87 例(C 组)在直视下成功放置连续椎旁阻滞装置的患者和 146 例(P 组)使用患者自控静脉镇痛装置的患者。记录两组患者术后苏醒后 1、3、6、12、24、36、48 小时静息和运动时的视觉模拟疼痛评分(VAS)、两种镇痛方法不良反应的发生率、术后肺部并发症的发生情况、急诊镇痛药物的使用情况和术后住院时间。

结果

C 组患者术后 1、3、6、12、24、36、48 小时静息和运动时的 VAS 评分均明显低于 P 组( < 0.001)。C 组不良反应、肺部并发症和急诊镇痛药物的发生率低于 P 组( < 0.05)。C 组的住院时间明显缩短,C 组的满意度明显高于 P 组( < 0.05)。

结论

椎旁阻滞用于微创食管癌根治术患者安全有效,不良反应和并发症发生率低,术后镇痛满意度高,有利于患者术后快速康复。

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