目的 回顾总结使用全身麻醉复合椎旁阻滞技术对普胸手术患者麻醉管理和恢复的影响。 方法 总结30例椎旁阻滞复合全身麻醉下完成贲门癌根治术患者（P组）的麻醉，与同时期30例在单纯全身麻醉下完成贲门癌根治术患者（G组）的麻醉过程进行对照研究总结。G组患者直接接受全身麻醉后接受手术治疗；P组患者首先清醒接受手术侧的椎旁间隙穿刺注入20 ml 0.375%罗哌卡因并留置导管后再接受全身麻醉开始手术治疗。比较患者麻醉中的用药量，麻醉管理情况。比较术后患者恢复情况，包括拔管清醒时间、静息和咳嗽疼痛视觉模拟评分（visual analogue scale， VAS）、术后镇痛药物的药量、术后24 h患者的整体满意程度进行比较。 结果 所有患者麻醉手术和恢复过程都顺利。P组患者术中舒芬太尼用量［（5±4） μg］显著低于G组［（26±4） μg］（P<0.01），维持麻醉七氟烷浓度P组［（1.41±0.12）%］也显著低于G组［（2.11±0.10）%］（P<0.01）。术后P组麻醉恢复时间［（45±18） min］显著短于G组［（100±20） min］（P<0.01），术后P组患者的咳嗽VAS评分显著低于G组，P组追加芬太尼用量［（0.11±0.12） mg］也显著少于G组［（0.42±0.11） mg］（P<0.01）。 结论 使用解剖标志定位实施椎旁阻滞与全身麻醉复合应用于食道等普胸手术中可以显著简化麻醉管理，减少麻醉药物使用，更有利于患者的苏醒和术后镇痛。
Ｏｂｊｅｃｔｉｖｅ To investigate the effect of general anesthesia combined with paravertebral block for thoracic surgery. Methods Retrospectively analyzed 30 patients（group P） under general anesthesia combined with paravertebral block for accepting radical resection of cardia carcinoma and 30 patients（group G） undergoing same surgery with only general anesthesia in the same period. Before general anesthesia， patients in group P received paravertebral nerve block in operating side with 20 ml 0.375% ropivacaine injected into paravertebral space and catheters were left after injection. The consumption of anesthetic drugs， anesthetic management， anesthetic recovering， postoperative visual analog scale（VAS） at rest and when coughing in both groups were recorded. Satisfaction of anesthesia was recorded 24 h postoperatively. Results The process of anesthesia and operation went well in all groups. The mean consumption of sulfentanyl and sevoflurane in group P was less than that in group G［（5±4） μg vs（26±4） μg］（P<0.01）. Recovery time in group P was shorter than that in group G［（45±18） min vs（100±20） min］（P<0.01）. Mean VAS scores when coughing were significantly decreased in group P（P<0.01）. The postoperative fentanyl consumption of patients in group P was significantly less than that in group G ［（0.11±0.12） mg vs （0.42±0.11） mg］（P<0.01）. Conclusions Using landmark technique in paravertebral block combined with general anesthesia for thoracic surgeries may simplify the anesthesia management and decrease anesthetics consumption in favor of anesthesia recovery and postoperative analgesia.
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