Application of thoracoscope assisted intercostal nerve block combined with nalbuphine for postoperative multimodal analgesia in lung segment resection surgery
10.3969/j.issn.1005-6483.2023.12.028
- VernacularTitle:胸腔镜直视下肋间神经阻滞联合纳布啡用于胸腔镜肺段切除术后多模式镇痛
- Author:
Xilong SUN
1
;
Huan LIU
;
Zhilin WU
Author Information
1. 430022 武汉,华中科技大学同济医学院附属协和医院麻醉科
- Keywords:
intercostal nerve block;
thoracoscopic lung segment resection surgery;
nalbuphine;
postoperative analgesia
- From:
Journal of Clinical Surgery
2023;31(12):1213-1216
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of thoracoscope assisted intercostal nerve block combined with nalbuphine for postoperative multimodal analgesia after lung segment resection surgery.Methods From April 2022 to September 2022,60 patients scheduled for thoracoscopic lung segment resection surgery were selected and divided into two groups according to the random number table,with 30 patients in each group.The patients in the observation group received intercostal nerve block under thoracoscope before closing the chest,and the postoperative analgesia pump was Naborphine combined with sufentanil for patient-controlled intravenous analgesia;In the control group,the thoracic cavity was closed directly,and sufentanil was used for patient-controlled intravenous analgesia.The visual analog pain score(V AS),the number of PCI A effective pressing,the situation of rescue analgesia and the occurrence of related adverse reactions were recorded 2 h,4 h,8 h,24 h and 48 h after surgery.Results The VAS scores at rest of the observation group at2h,4h,8h,24h and 48 h after operation 1.8±0.8,1.9±0.8,2.1±0.9,2.3±0.9,2.1±0.8,compared with control group 3.3±1.1,3.5±1.0,2.8±0.9,2.7± 0.7,2.6±0.8 were all significantly lower(P＜0.05).The VAS scores during activity of the observation group at 2 h,4 h,and 8 h after operation 2.2±0.6,2.3±0.6,2.5±0.9,compared with control group 3.9±1.9、3.9±1.7、3.3±1.7 were significantly lower(P＜0.05).The effective press times of PCIA in the observation group within 24 hours and 48 hours after operation were 2.7±1.5 and 5.4±2.3 times,while those in the control group were 5.2±3.4 and 10.2±6.0 times.The difference between the two groups was statistically significant(P＜0.05).The number of patients in the observation group receiving postoperative analgesia was less than that in the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).The satisfaction rate of patients in the observation group was higher than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Thoracoscope assisted intercostal nerve block combined with nalbuphine can be a good choice for postoperative multimodal analgesia in lung segment resection surgery.
