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Application of ultrasound-guided paravertebral nerve block in reconstruction of external ears with autogenous costal cartilage transplantation |
SUN Yuming1, YANG Jie1, LI Jiangwei2 |
1. Department of Anesthesia,Shandong Provincial Corps Hospital of the Chinese People’s Armed Police Force, Jinan 250014,China; 2. Department of Anesthesia,Tongren Second People’s Hospital, Tongren 554300,China |
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Abstract Objective To study the applicability of ultrasound-guided thoracic paravertebral nerve block in external ear reconstruction with autogenous costal cartilage transplantation.Methods Between May 2018 and November 2019, 60 children in the second stage of external ear reconstruction with costal cartilage transplantation were randomly divided into the general anesthesia group (group A) and paravertebral nerve block group (group B). The difference in anesthetic effect, postoperative analgesia, intraoperative general anesthesia dosage and postoperative adverse reactions was observed between the two anesthetic methods for external ear reconstruction.Results 1% propofol (725.69±145.50)mg and remifentanil (2129.90±536.72)μg were used in group B, while propofol (914.58±242.41)mg and remifentanil (3266.79±770.64)μg were used group A. The usage of the two drugs was significantly less in group B than in group A (P<0.05). The heart rate and blood pressure responses of group B were significantly lower than those of group A. The recovery time (T0)was (15.00±1.46)min in group A and(11.53±1.43)min in group B, which was significantly shorter than in group A (P<0.05). The incidence of such adverse reactions as cardiovascular events, nausea, vomiting and constipation was significantly lower in group B than in group A (P<0.05).Conclusions Ultrasound-guided thoracic paraspinal nerve block combined with general anesthesia has been applied to the reconstruction of external ears with autogenous costal cartilage transplantation. Compared with general anesthesia alone, the anesthetic effect of this approach is significant during operation. The hemodynamics is more stable. The dosage of drugs for general anesthesia is significantly reduced. The advantages of postoperative analgesia are obvious, recovery is faster, and there are fewer adverse reactions.
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Received: 10 February 2020
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[1] |
苏法仁,薄 琳,丁静华,等. 先天性小耳畸形的耳廓再造[J]. 中华耳科学杂志,2014,12(1):90-92.
|
[2] |
罗太君,李 坤,高广阔,等.超声引导下单点和两点胸椎旁神经阻滞对胸腔镜手术患者血流动力学和应激反应的影响[J].临床麻醉学杂志,2019,35(7):680-684.
|
[3] |
廖晓南,任书信,刘晨阳.自体肋软骨支架在小耳畸形耳再造术中的应用[J].中国医疗美容,2019,9(8):41-44.
|
[4] |
徐 艳,陈有林. 超声引导椎旁神经阻滞联合气管插管全身麻醉在临床开胸手术中的麻醉效果分析[J]. 医药前沿,2019,9(23):135-136.
|
[5] |
张隆盛,林旭林,张欢楷,等. 前锯肌平面阻滞与胸椎旁神经阻滞用于胸腔镜手术患者术后镇痛效果的比较[J]. 临床麻醉学杂志,2019,35(1):47-51.
|
[6] |
赵玉彪. 肋间神经阻滞对开胸术后镇痛效果的观察[J]. 中国临床实用医学,2014,5(1):51-52.
|
[7] |
李盼盼,郎贤平, 殷南昌,等.硬膜外麻醉与椎旁神经阻滞非气管插管单孔胸腔镜手术效果比较[J].肿瘤研究与临床,2020,32(1):52-55.
|
[8] |
冉茂琳,于布为, 薛庆生.胸椎旁神经阻滞严重并发症—全脊麻[J].临床麻醉学杂志,2019,35(12):1234-1236.
|
[9] |
张捍平,芮龙洁,李 冬.超声引导下单次竖脊肌平面阻滞与硬膜外自控镇痛在老年患者胸腔镜手术中的应用[J].武警医学,2020,31(1):43-46.
|
[10] |
吴宝城.高位胸椎旁神经根阻滞致全脊髓麻醉(附1例报告)[J]. 福建医药杂志,2001,23(2):80.
|
[11] |
Ding X, Jin S, Niu X, et al. A comparison of the analgesia efficacy and side effects of paravertebral compared with epidural blockade for thoracotomy: an updated meta-analysis[J]. PLoS One, 2014, 9(5):e96233.
|
[12] |
Breivik H,Stubhaug A. Management of acute postoperative pain:stilla long way to go[J]. Pain,2008,137(2):233-234.
|
[13] |
Hwang E G,Lee Y. Effectiveness of intercostal nerve block for management of pain in rib fracture patients[J]. J Exerc Rehabil,2014,10(4):241-244.
|
[14] |
Taketa Y, Fujitani T. A novel paralaminar in-plane approachfor ultrasound-guided continuous thoracic paravertebralblockusing microconvexarray transducer[J]. Reg Anesth Pain Med,2015, 40(4): 390.
|
[15] |
Krediet A C, Moayeri N, Geffen G J, et al. Different approa ches to ultrasound-guided thoracic paravertebral block: an illus trated review[J]. Anesthesiology, 2015, 123(2): 459-474.
|
[16] |
Detterbeck F C. Efficacy of methods of intercostal nerve blockade forpain relief after thoracotomy[J]. Ann Thorac Surg,2005,80(4):1550-1559.
|
[17] |
Matsota P,Livanios S,Marinopoulou E. Intercostal nerve block with bupivacaine for post-thoracotomy pain relief in children[J]. Eur J Pediatr Surg,2001,11(4):219-222.
|
|
|
|