RESUMEN
Objective:To investigate the effect of right stellate ganglion block (RSGB)-serratus anterior plane block (SAPB) combined with general anesthesia in thoracoscopic radical resection of lung cancer.Methods:A total of 90 patients who planned to undergo thoracoscopic radical resection of lung cancer in Xiangya Changde Hospital from March 2020 to September 2021 were prospectively selected and divided into 3 groups by random number table method: general anesthesia group (G group), (SAPB)+ general anesthesia group (SG group), RSGB+ SAPB+ general anesthesia group (RSG group), 30 cases in each group. The SG group received SAPB on the operative side before general anesthesia, and the RSG group received RSGB+ SAPB on the operative side before general anesthesia. After the blocking effect was determined, all patients were given general anesthesia in the same scheme according to their weight, and patients were given patient-controlled intravenous analgesia (PCIA) after surgery. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T 0), before intubation (T 1), 1 min after intubation (T 2), 5 min after intubation (T 3), at extubation (T 4) and 5 min after extubation (T 5). The intraoperative dosage of remifentanil, incidence of nausea and vomiting (PONV) within 24 hours after surgery, number of additional PCIA within 24 hours, the Visual Analogue Scale (VAS) of static and dynamic pain, the Bruggrmann Comfort Scale (BCS) and Richard Campbell Sleep Questionnaire (RSCQ) 24 hours after surgery were recorded. Results:Compared with T 0, the MAP and HR in 3 groups were increased 1 min after intubation (T 2) and at extubation (T 4), but the increases in RSG group were significantly less than those in G and SG groups (all P<0.05). The remifentanil dosage, PONV incidence and PCIA supplemental times in SG and RSG groups were less than those in G group, and the BCS score and RSCQ score were higher than those in G group (all P<0.05); the BCS score and RSCQ score in RSG group were higher than those in SG group (all P<0.05). Conclusions:RSGB+ SAPB combined with general anesthesia in thoracoscopic radical resection of lung cancer has little circulation fluctuation, good postoperative analgesia effect, less adverse reactions and high comfort level.
RESUMEN
Objective To investigate the appropriate ratio of propofol and remifentanil in total in travenous anesthesia for adult fiberoptic bronchoscopy.Methods 122 cases of adult patients who were examined under total intravenous anesthesia (TIVA) with fiberoptic bronchoscopy in Xiangya hospital were randomly divided into three groups regarding the mixed proportion of propofol and remifentanil:group Ⅰ including 42 cases,group Ⅱ 41 cases,group Ⅲ 39 cases;the mixed proportion of propofol and remifentanil in group Ⅰ was 400 mg∶ 1 mg,in group Ⅱ was 1 000 mg∶ 1 mg,and in group Ⅲ was 2 000 mg∶ 1 mg,were given during TIVA.In the surgery,the bispectral index (BIS) values were sustained between 45 and 60 and we compared the changes of vital signs,airway resistance,the incidence of bucking and airway spasm before and after anesthesia.Results Compared with group Ⅱ,the airway resistance and the incidence of bucking and airway spasm in group Ⅰ both significantly increased and the blood pressure fluctuation in group Ⅲ was greater significantly (P ＜ 0.05).Conclusions The appropriate ratio of propofol and remifentanil is 1 000 mg∶ 1 mg with total intravenous anesthesia in fiberoptic bronchoscopy,which results a stable hemodynamics,lower airway resistance,and lower incidence of bucking and airway spasm.