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目的探讨连续胸椎旁神经阻滞联合全身麻醉用于乳腺癌手术的麻醉效果。方法将乳腺癌患者192例随机分为研究组和对照组各96例,研究组采用连续胸椎旁神经阻滞联合全身麻醉,对照组采用全身麻醉,2组患者手术方法相同,治疗结束后对比2组患者4h、8h、12h、24h、48h安静和咳嗽时VAS评分、术后用药情况及清醒时间。结果研究组患者舒芬太尼和丙泊酚的用量均显著少于对照组,患者麻醉苏醒时间也显著短于对照组,差异均有统计学意义(P<0.05)。2组患者安静状态VAS评分差异不显著(P>0.05),研究组患者术后4h、8h、12h、24h、48h咳嗽状态VAS评分均显著低于对照组,差异均有统计学意义(P<0.05)。结论连续胸椎旁神经阻滞联合全身麻醉用于乳腺癌手术的麻醉术中用药少、术后镇痛效果好,并能有效缩短患者苏醒时间,适合临床中广泛推广应用。
Objective To investigate the anesthetic effect of continuous thoracic paravertebral nerve block combined with general anesthesia for breast cancer surgery. Methods Ninety-two patients with breast cancer were randomly divided into study group (96 cases) and control group (96 cases). The study group was treated by continuous thoracic paravertebral nerve block combined with general anesthesia. The control group received general anesthesia. The operation method was the same in both groups. Group 4h, 8h, 12h, 24h, 48h VAS score when quiet and cough, postoperative medication and awake time. Results The dosage of sufentanil and propofol in the study group were significantly less than those in the control group. The anesthesia recovery time was also significantly shorter in the study group than in the control group, with significant differences (P <0.05). There was no significant difference in VAS score between the two groups (P> 0.05). VAS scores of cough in 4h, 8h, 12h, 24h, 48h after operation in study group were significantly lower than those in control group (P < 0.05). Conclusion Continuous thoracic paravertebral nerve block combined with general anesthesia for anesthesia in breast cancer surgery less medication, good analgesic effect, and can effectively shorten the recovery time of patients, suitable for wide application in clinical practice.