肋间神经阻滞复合全麻联合静脉自控镇痛对胸腔镜肺大疱切除术 患者术后镇痛效果及恢复情况的影响.

Objective: To explore the postoperative analgesic effect and patient recovery of intercostal nerve block combined with general anesthesia and patient-controlled intravenous analgesia in thoracoscopic bullectomy. Methods: The subjects were selected from80 patients who underwent thoracoscopic bullectomy. They were divided into control group and observation group according to simple digital table method, with 40 patients in each group. The control group received general anesthesia combined with patient-controlled intravenous analgesia, and the observation group combined with intercostal nerve block on this basis to compare the postoperative analgesia effect and recovery of the two groups. Results: Compared with pre-operation, the CD4+ and CD4+/CD8+ of patients in the two groups decreased at first and then increased at 24 hours after operation, and the observation group was higher than the control group at all time points; The CD8+of patients in both groups increased first and then decreased, and the observation group was lower than the control group at all time points (P＜0.05) . At 24 and 48 hours after operation, the number of analgesic pump pressure and the total amount of analgesic drug infusion in the observation group were decreased compared with the control group (P＜0.05) . Compared with the control group, the time from the end of operation to extubation, the time to get out of bed and the time to stay in hospital were shorter in the observation group (P＜0.05) . Compared with the control group (22.50%, 20.00%), the total incidence of complications and adverse reactions in the observation group (2.50%, 5.00%) was lower (P＜0.05) . Conclusion: The application of intercostal nerve block combined with general anesthesia combined with patient-controlled intravenous analgesia in thoracoscopic bullectomy has achieved remarkable analgesic effect, which can not only reduce the postoperative pain of patients, but also reduce the body’s immunosuppression, without increasing the risk of complications and adverse reactions. The clinical application is safe. [ABSTRACT FROM AUTHOR]