【摘要】 目的 :比较肋间神经阻滞麻醉和静脉麻醉在乳房肿块切除术中的镇痛效果 ,并发症 ,不良反应及费用 ,为麻醉医师选择合理的麻醉方式提供依据。方法 :收集复旦大学附属肿瘤医院 1994年 1月～ 2 0 0 4年 8月 10年间 36 89例经肋间神经阻滞麻醉和 35 6例经静脉麻醉行乳房肿块切除术的病例。比较两种麻醉方式的镇痛效果 ,并发症 ,不良反应及费用。结果 :静脉组镇痛满意率 99% ,术中呼吸抑制需面罩加压通气为 5 5例 ,15 .5 % ,术后恶心呕吐 5 6例 ,15 .6 % ,麻醉费用平均 70 5 .4元。肋阻组镇痛满意率 92 .5 % ,并发症气胸 2例 ,0 .0 5 4 % ,局麻药中毒 5例 ,0 .14 % ,均为双侧肋间神经阻滞 ,平均费用 2 33.5 6元。结论 :两种麻醉方式各有利弊 ,麻醉医师应综合分析病人病情和自身对该技术的掌握程度 ,做出一个合理的麻醉选择 ,在确保安全无痛的前提下 ,兼顾病人的经济承受力。更多还原

【Abstract】 Objictive:Compare analgesia effect, compli ca tions, side effect and cost between intercostal nerve block and intravenous anea sthesia and provide a theroy for aneasthesiologists to make a right choice in an easthesia.Methods:In the retrospective analysis of 3689 cases of intercost als nerve block and 356 cases of intravenous aneasthesia in lumpectomy from Janu nary 1994 to August 2004 in Cancer Hospital of Fudan University, compare their a nalgesia effect, complications, side effect and cost. Results: In the intravenous aneasthesia group,99% cases achieve satisfied analgesia effect, the incidence of respiratory depression with mask ve ntilation during the operation is 15.5%, the incidence of postoperative nausea a nd vomiting is 15.6%, the average cost is 705.4 RMB. In the intercostal nerve bl ock aneasthesia group 92.5% cases achieve satisfied analgesia effect, the incide nce of pneumothorax is 0.054%, the incidence of local aneasthetic toxicity is 0. 14%, the average cost is 233.56RMB.Conclusion: We can see both advantages and disadvantages in thes e two kind of aneasthesia, we have to integrate various factors to make the righ t choice of aneasthesia. Safety and painless is the first priority, whereas the economic capability of the patient should be considered too.更多还原