Wang Qiang, Guo Jiao, Hou Minna
Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University No. 277, Yanta West Road, Xi'an 710000, Shaanxi, P. R. China.
Department of Anesthesiology, Shaanxi Provincial People's Hospital 256 Youyi West Road, Xi'an 710000, Shaanxi, P. R. China.
Am J Transl Res. 2022 Sep 15;14(9):6277-6285. eCollection 2022.
To explore the effect of intercostal nerve block (INB) combined with oxycodone on the postoperative cognitive ability in elderly patients undergoing radical resection of lung cancer (LC).
A total of 135 elderly patients who underwent radical LC operations in our hospital from April 2019 to July 2021 were enrolled for retrospective analysis. There are 71 patients, who received INB with 0.5% ropivacaine 20 mL and oxycodone 5 mg (intravenous injection) before chest closure, were assigned to the observation group (OG), while 64 patients, who received a single oxycodone injection (5 mg) into the anterior thoracic vein, were assigned as the control group (CG). The cognitive function of patients was assessed by a mini mental state examination (MMSE) before and 24 h after operation. Also, the visual analogue scale (VAS), sedation score (Ramsay) and the occurrence of adverse reactions within 48 h after surgery were compared. Additionally, the changes of heart rate (HR), blood oxygen saturation (SpO) and central venous pressure (CAP) at 4 h, 8 h, 12 h and 24 h after operation were observed, and the pressure times of analgesia pump within 24 h and the satisfaction rates of postoperative analgesia were compared between the two groups.
After operation, compared with the CG, the MMSE in the OG was dramatically higher (P<0.05), while the incidence of adverse reactions (P<0.05) and the VAS score (P<0.05) in the OG were significantly lower. There was no remarkable difference in postoperative HR, SpO and MAP between the two groups (P>0.05). The number of postoperative analgesia pump pressing in the OG was lower than that in the CG (P<0.05), and the satisfaction rate of postoperative analgesia in the OG was higher (P<0.05).
INB combined with oxycodone has a better application effect in senile LC radical operation. It can improve the postoperative cognitive function and reduce postoperative adverse reactions and pain with high safety.
探讨肋间神经阻滞（INB）联合羟考酮对老年肺癌（LC）根治术患者术后认知能力的影响。
选取2019年4月至2021年7月在我院行LC根治术的135例老年患者进行回顾性分析。其中71例患者在关胸前接受20 mL 0.5%罗哌卡因联合5 mg羟考酮（静脉注射）的INB，被分配至观察组（OG）；64例患者接受单次5 mg羟考酮注入胸前静脉，被分配为对照组（CG）。分别于术前及术后24 h采用简易精神状态检查表（MMSE）评估患者的认知功能。同时，比较视觉模拟评分法（VAS）、镇静评分（Ramsay）及术后48 h内不良反应的发生情况。此外，观察术后4 h、8 h、12 h及24 h时心率（HR）、血氧饱和度（SpO）及中心静脉压（CAP）的变化，并比较两组24 h内镇痛泵按压次数及术后镇痛满意度。
术后，与CG相比，OG的MMSE显著更高（P<0.05），而OG的不良反应发生率（P<0.05）和VAS评分（P<0.05）显著更低。两组术后HR、SpO及MAP差异无统计学意义（P>0.05）。OG术后镇痛泵按压次数低于CG（P<0.05），且OG术后镇痛满意度更高（P<0.05）。
INB联合羟考酮在老年LC根治术中具有较好的应用效果。它能改善术后认知功能，降低术后不良反应及疼痛，安全性高。
