关键词: 镇痛;美蓝;神经阻滞;胸外科手术

    中图号:R614.31

    摘 要:目的 探讨开胸手术用美蓝肋间神经阻滞超前镇痛与硬膜外吗啡镇痛效果. 方法 择期开胸手术30例，随机分为3组，每组10例.A组为对照组，术后以传统方法间断im镇痛药;B组开胸前以10g·L-1 美蓝2mL+3.75g·L-1 布比卡因10mL手术区肋间神经阻滞;C组手术后经硬膜外腔注入3.75g·L-1 布比卡因5mL+吗啡2mg.观察术后48h内3组患者使用镇痛药次数及镇痛维持时间;术后8，24及48h视觉模拟疼痛评分(VAS)及副作用. 结果 B和C组给镇痛药次数明显少于A组(P<0.05);镇痛维持时间:B(38±16)h>C(20±13)h>A(5±5)h(P<0.05);术后24h内B和C组疼痛明显轻于A组，48h时B组疼痛明显轻于A和C组(P<0.05). 结论 用美蓝行肋间神经阻滞具有止痛确切、维持时间长、经济、简便、副作用小等优点，可安全、有效地用于开胸手术超前镇痛.

    Clinical effects of intercostal nerve block with methylene blue as preemptive analgesia for thoraco┐tomy

    YUAN Qing-Xia，XU Rui-Bing，HE Xiu-Li，HU Bing

    Department of Anesthesiology，Department of Thoracic Surgery，Affiliated Hospital，Medical Col-lege，Yan'an University，Yan'an716000，China

    Keywords:analgesia;thoracic surgical procedures;methy-lene blue;nerve block

    Abstract:AIM To investigate the effects of preemptive analgesia for post thoracotomy with methylene blue inter-costal nerve block analgesia and epidural morphine analgesia.METHODS Thirty patients undergoing thoractomy were randomly divided into three groups with10patients in each net group.A:control group ......