竖脊肌平面阻滞联合喉罩保留自主呼吸在胸腔镜肺叶切除术麻醉中的应用

doi:10.3969/j.issn.1006-6233.2019.03.008

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Abstract Objective:To investigate the efficacy and safety of spinal plane block combined with laryngeal mask self-help breathing in anesthesia for thoracoscopic pulmonary lobectomy. Methods:40 cases of patients with elective thoracoscopic lobectomy in our hospital were selected and randomly divided into the erector spine plane block combined with the laryngeal mask and retained spontaneous breathing anesthesia group(group C) and the double-lumen endotracheal intubation general anesthesia group (group S) with 20 in each.The concentration levels of plasma cortisol,norepinephrine and epinephrine were measured in the two groups before anesthesia induction (T1),10 minutes after the beginning of operation (T2),30 minutes after the beginning of operation (T3) and 10 minutes after the end of operation (T4);The highest PetCO₂ (PetCO₂max) and the lowest SpO₂ (SpO₂min) were recorded during surgery in the two groups;The operative time,anesthesia recovery time,hospitalization time,postoperative complications,postoperative VAS pain and surgeon's satisfaction were compared between the two groups.Results:Compared with T1, the levels of cortisol, norepinephrine and epinephrine at T2, T3 and T4 in both groups increased (P<0.05). At T2, T3 and T4, the contents of cortisol, norepinephrine and epinephrine in group C were lower than those in group S at the same time point (P<0.05). Compared with group S,patients in group C experienced increased PetCO₂max (P<0.05),decreased SpO₂min (P<0.05),shortened anesthesia recovery time and hospitalization time (P<0.05), decreased postoperative VAS pain score (P<0.05),and significantly decreased the incidence of postoperative laryngopharyngeal pain and hoarseness (P<0.05).There was no difference in operative time and surgeon's satisfaction between the two groups (P>0.05).Conclusion: The erector spinae plane block combined with laryngeal mask and retained spontaneous breathing in anesthesia is certain feasible for thoracoscopic lobectomy,which does not affects the surgical process and effectively inhibits the surgical stress response,accelerates patient recovery and reduces complications.

Key words： Erector spinae plane block Laryngeal mask Spontaneous breathing Thoracoscopy Lobectomy

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	HU Liqun
	LI Li
	FU Jinsong
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HU Liqun,LI Li,FU Jinsong, et al. Application of Vertical Spinal Muscle Planar Block Combined with Laryngeal Mask Retention for Autonomous Breathing in Thoracoscopic Lung Lobectomy Anesthesia[J]. HeBei Med, 2019, 25(3): 559-562.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2019.03.008 OR http://www.hbyxzzs.cn/EN/Y2019/V25/I3/559

[1] Hardavella G,Papakonstantinou N,KarampinisI,et al.Video-assisted thoracoscopic surgery(VATS)with nonintubated spontaneous breathing general anesthesia using laryngeal mask(LMA)[J].European Respiratory Journal,2015,46(suppl 59):OA1742.
[2] 史经伟,杨如松,邵丰,等.非气管插管保留自主呼吸麻醉下单孔胸腔镜技术的临床应用[J].重庆医学,2018,47(4):480-481.
[3] ForeroM,Adhikary S D,LopezH,et al.The erector spinae plane block:a novel analgesic technique in thoracic neuropathic pain[J].Regional Anesthesia&Pain Medicine,2016,41(5):621.
[4] ForeroM,RajarathinamM,AdhikaryS,et al.Continuous erector spinae plane block for rescue analgesia in thoracotomy after epidural failure:a case report[J].A&A Case Reports,2017,8(10):254.
[5] 沈江,徐青荣,蒋波,等.全凭静脉麻醉下保留自主呼吸行胸腔镜手术的安全性评估[J].南京医科大学学报(自然科学版),2018(1):108-111.
[6] 黄理进,张婵娟,陈海林,等."快速康复"胸科麻醉技术用于胸腔镜手术患者中的效果研究[J].中国医学创新,2018(10).
[7] 李琴琴,陈楠,杨涛,等.超声引导下椎旁神经阻滞用于非插管胸腔镜手术麻醉体会[J].实用医学杂志,2017,33(13):2248-2249.
[8] 铁植,于建设,都义日,等.非气管插管保留自主呼吸麻醉技术在胸腔镜手术中应用进展[J].国际医药卫生导报,2017(21):3305-3312.
[9] 李诗恩,胡安民,张中军.保留自主呼吸非插管麻醉在胸腔镜手术中的应用进展[J].医学综述,2017,23(20):4132-4136.
[10] 于健,单士强,孙宗建,等.右美托咪定不同给药方式对患者经鼻清醒气管插管应激反应的对比研究[J].中国现代医学杂志,2017(30):103-108.
[11] Shi Y,YuH,HuangL,et al.Postoperative pulmonary complications and hospital stay after lung resection surgery:a meta-analysis comparing nonintubated and intubated anesthesia[J].Medicine,2018,97(21):e10596.
[12] Irons J F,Miles L F,Joshi K R,et al.Intubated versus nonintubated general anesthesia or video-assisted thoracoscopic surgery-A case-control study[J].Journal of Cardiothoracic&Vascular Anesthesia,2016,31(2).