【摘要】 目的观察超声引导下肋间神经阻滞麻醉在乳腺肿块微创旋切术中的应用效果。方法 60例择期行单侧乳房单发肿块切除术女性患者,年龄19~48岁,ASAⅠ~Ⅱ级,随机分为超声引导下肋间神经阻滞麻醉组(A组)和局部穿刺点、穿刺针道及乳腺肿块下方与胸大肌之间的间隙沿针道局部浸润麻醉组(B组),局麻药均为1%利多卡因+0.25%盐酸罗哌卡混合液。观察两组麻醉操作时间、麻醉阻滞完善时间、麻醉阻滞持续时间、手术过程中VAS评分、局麻药用量、麻醉阻滞成功率、麻醉总体满意率和麻醉过程中不良反应发生情况等。结果与B组比较,A组麻醉操作时间长,麻醉阻滞持续时间长,手术中VAS评分低、局麻药用量少,麻醉阻滞成功率和总体满意率高(P<0.05),两组麻醉阻滞完善时间相当,均无严重不良反应发生。结论超声引导下肋间神经阻滞麻醉用于在乳腺肿块微创旋切手术,麻醉药用量少,阻滞效果完善,不良反应少,是一种安全有效的麻醉方法。更多还原

【Abstract】 Objective To observe the effect of ultrasound-guided intercostals nerve block anesthesia in the minimally invasive exsection of breast lump. Methods Sixty female patients aged19 ~ 48 years scheduled for the minimally invasive exsection of breast lump,ASA Ⅰ or Ⅱ,were randomly divided into two groups,the ultrasound-guided intercostals nerve block anesthesia group( group A) and the local infiltration anesthesia along the needle way group( group B),were used 1% lidocaine + 0. 25% ropivacaine in both groups. The time for the anesthesia operation,for the anesthesia to complete and for the anesthesia duration,the VAS score in the process of surgery,the dosage of local anesthetics,anesthetic success and satisfaction rate,and the adverse reactions were observed. Results Group A showed longer time for the anesthesia operation and duration,lower VAS score in the process of surgery,less the dosage of local anesthetics,higher anesthetic success and satisfaction rate( P < 0. 05). No serious adverse reactions were found in both groups. Conclusion Ultrasound-guided intercostals nerve block anesthesia with less dosage of anesthetic,better block effect,and less adverse reactions,is a safe and effective method in the minimally invasive exsection of breast lumps.更多还原