青岛大学学报（医学版）2023，Vol.59Issue(6)：917-920,4.DOI:10.11712/jms.2096-5532.2023.59.188
超声引导下SAPB联合ICNB在机器人肺切除术后的镇痛效果
ANALGESIC EFFECT OF ULTRASOUND-GUIDED SERRATUS ANTERIOR PLANE BLOCK COMBINED WITH INTERCOSTAL NERVE BLOCK AFTER ROBOT-ASSISTED PULMONARY RESECTION
摘要
Abstract
Objective To investigate the analgesic effect of ultrasound-guided serratus anterior plane block(SAPB)com-bined with intercostal nerve block(ICNB)in patients undergoing robot-assistedthoracic surgery(RATS)pulmonary resection.Methods A total of 60 patients who planned to undergo RATS pulmonary resection were randomly divided into SAPB+ICNB group(group A)and local infiltration anesthesia group(group B),with 30 patients in each group.After the completion of surgery,SAPB combined with ICNB was performed for group A,and local infiltration anesthesia was performed for group B.After surgery,patient-controlled analgesia pump was used for the patients in both groups.Numerical Rating Scale(NRS)score at rest and while coughing was recorded at the time when the patients left the postanesthesia care unit(PACU)and at 6,24,and 48 h after surgery,as well as the maximum NRS score within 48 h and its occurrence time;mean arterial pressure(MAP),heart rate(HR),and pulse oxygen saturation(SpO2)were recorded at the time when the patients left the PACU and at 6,24,and 48 h after surgery;the amount of the drug in analgesia pump used and the number of administrations of remedy drugs were recorded within 48 h after surgery;the incidence rates of adverse reactions were also recorded,including cardiovascular adverse events,respiratory depres-sion,and postoperative nausea and vomiting(PONV).Results Compared with group B,group A had a significantly lower NRS score at rest and while coughing at 24 h after surgery and a significantly lower maximum NRS score within 48 h after surgery(F= 17.277,6.423;P<0.05),as well as a significantly longer time to the occurrence of maximum NRS score(t=4.131,P<0.05).There were no significant differences between the two groups in MAP,HR,and SpO2 at each time point after surgery(P>0.05).Compared with group B,group A had significantly lower amount of the drug in analgesia pump used,number of times of remedial anal-gesia,and incidence rate of PONV(F=6.365,χ2 =4.232,5.564;P<0.05),while there were no significant differences in the inci-dence rate of other adverse reactions between the two groups(P>0.05).Conclusion Compared with local infiltration anesthesia,ultrasound-guided SAPB combined with ICNB can better alleviate pain after RATS pulmonary resection,prolong the duration of analgesia,and maintain stable respiration and circulation,without increasing the incidence rate of adverse reactions,and therefore,it is suitable for pain management after RATS pulmonary resection.关键词
神经传导阻滞/前锯肌/肋间神经/机器人手术/肺切除术/镇痛Key words
nerve block/serratus anterior muscle/intercostal nerves/robotic surgical procedures/pneumonectomy/analgesia分类
医药卫生引用本文复制引用
李琳,刘英志..超声引导下SAPB联合ICNB在机器人肺切除术后的镇痛效果[J].青岛大学学报（医学版）,2023,59(6):917-920,4.基金项目
青岛市公共领域科技支撑计划项目(11-2-3-1-(16)-nsh) （11-2-3-1-(16）
