关键词: 肋间神经阻滞, 胸腔镜肺段切除术, 纳布啡, 术后镇痛

Abstract: Objective To evaluate the effect of thoracoscope assisted intercostal nerve block combined with nalbuphine for postoperative multimodal analgesia after lung segment resection surgery.  Methods From April 2022 to September 2022,60 patients scheduled for thoracoscopic lung segment resection surgery were selected and divided into two groups according to the random number table,with 30 patients in each group.The patients in the observation group received intercostal nerve block under thoracoscope before closing the chest,and the postoperative analgesia pump was Naborphine combined with sufentanil for patient-controlled intravenous analgesia;In the control group,the thoracic cavity was closed directly,and sufentanil was used for patient-controlled intravenous analgesia.The visual analog pain score(VAS),the number of PCIA effective pressing,the situation of rescue analgesia and the occurrence of related adverse reactions were recorded 2h,4h,8h,24h and 48h after surgery.Results The VAS scores at rest of the observation group at 2h,4h,8h,24h and 48h after operation 1.8±0.8,1.9±0.8,2.1±0.9,2.3±0.9,2.1±0.8,compared with control group 3.3±1.1,3.5±1.0,2.8±0.9,2.7±0.7,2.6±0.8 were all significantly lower(P<0.05).The VAS scores during activity of the observation group at 2h,4h,and 8h after operation 2.2±0.6,2.3±0.6,2.5±0.9,compared with control group 3.9±1.9、3.9±1.7、3.3±1.7 were significantly lower(P<0.05).The effective press times of PCIA in the observation group within 24 hours and 48 hours after operation were 2.7±1.5 and 5.4±2.3 times,while those in the control group were 5.2±3.4 and 10.2±6.0 times.The difference between the two groups was statistically significant(P<0.05).The number of patients in the observation group receiving postoperative analgesia was less than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The satisfaction rate of patients in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion Thoracoscope assisted intercostal nerve block combined with nalbuphine can be a good choice for postoperative multimodal analgesia in lung segment resection surgery.

Key words: intercostal nerve block, thoracoscopic lung segment resection surgery, nalbuphine, postoperative analgesia