Observation on the clinical effectiveness of pulsed radiofrequency with intercostal nerve block for postoperative analgesia after elderly thoracoscopic lung surgery

SHI Jiao-hui; WANG Tao; XU Xiao-yan; ZHOU Qiao-lin; DAI Ti-jun

doi:10.11659/jjssx.10E023077

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Observation on the clinical effectiveness of pulsed radiofrequency with intercostal nerve block for postoperative analgesia after elderly thoracoscopic lung surgery

Anesthesia | 更新时间：2024-11-18

- Observation on the clinical effectiveness of pulsed radiofrequency with intercostal nerve block for postoperative analgesia after elderly thoracoscopic lung surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 11, Pages: 933-936(2024)
- 作者机构：
  
  1.徐州医科大学附属沭阳医院麻醉科，江苏沭阳223600
  2.徐州医科大学麻醉药理学教研室，江苏徐州 221004
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.10E023077
  CLC： R614
- Published：25 November 2024，
  
  Received：18 October 2023，
- 稿件说明：
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石教辉,汪涛,徐小艳等.脉冲射频式肋间神经阻滞用于老年肺部胸腔镜术后镇痛的临床效果观察[J].局解手术学杂志,2024,33(11):933-936.

SHI Jiao-hui,WANG Tao,XU Xiao-yan,et al.Observation on the clinical effectiveness of pulsed radiofrequency with intercostal nerve block for postoperative analgesia after elderly thoracoscopic lung surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):933-936.
石教辉,汪涛,徐小艳等.脉冲射频式肋间神经阻滞用于老年肺部胸腔镜术后镇痛的临床效果观察[J].局解手术学杂志,2024,33(11):933-936. DOI： 10.11659/jjssx.10E023077.

SHI Jiao-hui,WANG Tao,XU Xiao-yan,et al.Observation on the clinical effectiveness of pulsed radiofrequency with intercostal nerve block for postoperative analgesia after elderly thoracoscopic lung surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(11):933-936. DOI： 10.11659/jjssx.10E023077.

摘要

目的

探讨脉冲射频（PRF）式肋间神经阻滞对肺部胸腔镜手术老年患者镇痛效果、认知功能及术后谵妄的影响。

方法

选择我院行肺部胸腔镜手术的90例老年患者为研究对象，随机分为对照组（局部麻醉药物肋间神经阻滞）和PRF组（PRF式肋间神经阻滞），统计并比较2组患者的疼痛评分、镇痛效果、认知功能、术后谵妄及神经功能障碍情况。

结果

术后48 h及术后72 h，PRF组患者静息和咳嗽状态的疼痛评分均明显低于对照组（

0.05）。PRF组患者术后72 h内镇痛泵按压次数、补救镇痛占比及围术期舒芬太尼用量均明显少于对照组（

0.05）。术后48 h及术后72 h，PRF组患者认知功能评分显著高于对照组（

0.05）。术后72 h，PRF组患者谵妄发生率显著低于对照组（

0.05）。术后1个月、2个月及3个月，2组患者肋间神经功能障碍发生率比较，差异均无统计学意义（

0.05）。

结论

PRF式肋间神经阻滞能够有效缓解肺部胸腔镜手术老年患者的术后疼痛，减少术后阿片类药物用量，改善术后认知功能状况，降低术后谵妄发生率，且不影响肋间神经功能，安全可靠。

Abstract

Objective

To investigate the effects of pulsed radiofrequency （PRF） with intercostal nerve block on analgesia analgesia effect，cognitive function and postoperative delirium in elderly patients undergoing thoracoscopic lung surgery.

Methods

Ninety elderly patients undergoing thoracoscopic lung surgery in our hospital were randomly divided into the control group （intercostal nerve block with local anesthetic drugs） and the PRF group （PRF with intercostal nerve block）. The pain score， analgesic effect， cognitive function， postoperative delirium and neurological dysfunction of the two groups were compared.

Results

The pain scores of resting and coughing state 48 hours and 72 hours after surgery in the PRF group were significantly lower than those in the control group （

0.05）.The number of analgesic pump compression and proportion of supplemental analgesia within 72 hours after surgery and perioperative sufentanil dosage in the PRF group were significantly less than those in the control group （

0.05）. The cognitive function scores 48 hours and 72 hours after surgery in the PRF group were significantly higher than those in the control group （

0.05）. The incidence of delirium 72 hours after surgery in the PRF group was significantly lower than that in the control group （

0.05）. There was no significant difference in the incidence of intercostal nerve dysfunction 1 month， 2 months and 3 months after surgery between the two groups （

0.05）.

Conclusion

PRF with intercostal nerve block can effectively relieve pain after elderly thoracoscopic lung surgery， reduce postoperative opioid consumption， improve postoperative cognitive function， and decrease postoperative delirium incidence without affecting the intercostal nerve function， which is safe and reliable.

关键词

脉冲射频肋间神经阻滞胸腔镜手术术后镇痛认知功能术后谵妄

Keywords

pulsed radiofrequencyintercostal nerve blockthoracoscopic surgerypostoperative analgesiacognitive functionpostoperative delirium

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