Clinical Study Of Ultrasound-Guided Intercostal Nerve Block Combined With PCIA Analgesia In Elderly Patients With Thoracotomy

Objective: To investigate the analgesic effect of preoperative ultrasound-guided intercostal nerve block combined with postoperative PCIA in elderly patients with thoracotomy and its effect on postoperative recoveryMethods: From June 2017 to December 2018 in downlink elective general anesthesia through rib of 90 cases of elderly patients with open thoracic esophageal cancer radical,male 49 cases female 41 cases,aged between 65-79,ASA ? ~ ? level.30 cases in each group were randomly divided into three groups,namely group S(simple 3.0ug/kg sufentanil intravenous analgesia).RS1 group(0.75% ropivacaine intercostal nerve block+3.0ug/kg sufentanil venous analgesia);RS2 group(0.75% ropivacaine intercostal nerve block +1.5ug/kg sufentanil venous analgesia).Observe the three groups during after pull out urinous catheter vital signs,4,8,12,24 hours after awakening patients VAS score,Prince Henry scoring method and analgesia pump control number within 24 hours,the recovery of postoperative respiratory function and postoperative adverse reactions.Results: There was no significant difference in preoperative general conditions between the three groups(P>0.05).The intraoperative and postoperative vital signs of RS1 group and RS2 group were more stable than those of S group(P<0.05).Compared with group S,there was no significant difference in VAS at each time point in the RS2 group(P>0.05).The RS1 group was significantly decreased(P<0.05).Compared with group S,the p-h score of RS1 group and RS2 group was significantly decreased,and that of RS1 group was significantly lower than that of RS2 group.Both PaO2 and PaCO2 in RS1 group and RS2 group were better than those in S group(P<0.05).Conclusion:preoperative intercostals nerve block in combination with small dose of sufentanil postoperative PCIA can effectively relieve pain,reduce the postoperative pulmonary complications,and reduce the dosage of sufentanil,elderly patients with postoperative management.