|
|
|
| Ultrasound-guided PVB in PCNL Surgery and its Effect on Inflammatory Stress Response |
| PENG Hong, ZHEN Dong, LIU Hong |
| Department of Ultrasound, Dazhou Integrated Hospital of Traditional Chinese and Western Medicine, Dazhou, Sichuan 635000 |
|
|
|
|
Abstract 【Objective】To investigate the effect of ultrasound-guided paravertebral nerve block anesthesia (PVB) in percutaneous nephrolithotomy (PCNL) and its effect on inflammatory stress response. 【Methods】 One hundred and twenty cases of renal calculi undergoing PCNL were randomly divided into PVB group (ultrasound-guided PVB) and general anesthesia group (general anesthesia), 60 cases each. Before anesthesia (T0), 10 minutes after anesthesia (T1), after establishment of lithotripsy channel (T2), during lithotripsy (T3), heart rate (HR) after operation (T4) and mean arterial pressure (MAP) were compared between the two groups. The changes of serum interleukin-6 (IL-6), IL-10, tumor necrosis factor-alpha (TNF-α) and cortisol before and 24 hours after operation were compared between the two groups.The dosage of sufentanil 24 hours after operation and the times of pressing by PCIA pump were compared between the two groups.【Results】 There was no significant difference between the two groups at T0 (P>0.05); HR value in PVB group was lower than that in the general anesthesia group at T1 and T2, and MAP value was higher than that in the general anesthesia group (P<0.05); serum IL-6, TNF-αand cortisol in the PVB group were lower than those in the general anesthesia group at 24h after operation, and IL-10 was higher than that in the general anesthesia group (P<0.05); sufentanil dosage and PCIA pump compression times in PVB group were lower than those in general anesthesia group at 24h after operation (P<0.05) 【Conclusion】Ultrasound-guided application of PVB in PCNL is conducive to maintaining hemodynamic stability, alleviating inflammatory stress induced by surgery, reducing sufentanil dosage and PCIA pressing times.
|
|
Received: 17 July 2018
|
|
|
|
|
|
[1] 胡嘏, 杨欢, 彭鄂军,等. 超声引导椎旁神经阻滞麻醉用于经皮肾镜取石术的疗效观察[J].中华泌尿外科杂志, 2017, 38(3):201-205.
[2] 周明, 果佳, 王智勇,等. 局麻下超声引导经皮肾镜取石术[J].西南国防医药, 2014, 24(2):191-192.
[3] 朱荣誉, 吴述轩, 叶刚. 经皮肾镜钬激光碎石术不同体位对椎管内麻醉患者血流动力学及术中不良反应的影响[J].医学临床研究, 2014, 31(9):1729-1731.
[4] Kang C, Kim SB, Heo YM,et al.Comparison of time to operation and efficacies of ultrasound-guided nerve block and general anesthesia in emergency external fixation of lower leg fractures (AO 42, 43, 44)[J].J Foot Ankle Surg,2017, 56(5):1019-1024.
[5] 魏国华, 丁正年. 经皮肾镜手术的麻醉管理[J].临床麻醉学杂志, 2014, 30(3):301-303.
[6] 邝世航, 黄双艺, 乐有为,等. B超联合实时彩色多普勒超声在经皮肾镜取石术中的应用效果[J].广西医学, 2017, 39(11):1728-1730.
[7] 黄宁结, 吕国荣, 张朝贤,等. 超声引导肾穿刺在经皮肾镜取石术中的临床应用[J].实用临床医药杂志, 2017, 21(9):160-162.
[8] Guay J, Suresh S, Kopp S.The use of ultrasound guidance for perioperative neuraxial and peripheral nerve blocks in children:a cochrane review[J].Anesth Analg,2017, 2(3):948-958. |
|
|
|
2019, Vol. 36 
