摘要
Abstract
Objective:To investigate the effect of esketamine combined with serratus anterior plane(SAP)block on postoperative analgesia and inflammatory response in patients undergoing thoracoscopic lobectomy.Method:84 patients who underwent thoracoscopic lobectomy in the Ezhou Egang Hospital From January 2023 to December 2024 were selected for study.The patients were randomly divided into SAP block group(control group)and esketamine combined with SAP block group(combined group),with 42 cases in each group.Before induction of anesthesia,both groups were given SAP block.Before skin incision,the combined group was given esketamine pumping at 0.25 mg·kg-1·h-1)until 30 min before operation,and the control group was given normal saline pumping accordingly.The remaining anesthesia and analgesia regimens of the two groups were the same.The visual analogue scale(VAS)scores were recorded at 2 h,8 h,24 h and 48 h after the operation.The intraoperative and postoperative analgesia of patients were recorded.The Quality of Recovery-15(QoR-15)scores were recorded at 1 day before operation and 2 days after operation respectively.Before the operation and 24 h after operation,the serum C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)were measured.Result:Compared with the control group,the VAS scores of the combined group were lower at 2 h,8 h and 24 h after operation,with statistically significant differences(P<0.05),the intraoperative dosage of propofol,remifentanil and postoperative dosage of sufentanil in the combined group were reduced,with statistically significant differences(P<0.05).Compared with the control group at 1 day and 2 d after the operation,the QoR-15 score of the observation group was higher,with statistically significant differences(P<0.05).At the 24 h postoperative mark,serum CRP and TNF-α levels were lower in the observation group than those in the control group,with statistically significant differences(P<0.05).Conclusion:The application of esketamine combined with SAP block in thoracoscopic lobectomy can enhance the postoperative analgesic effect,reduce the inflammatory response and improve the quality of postoperative recovery.关键词
胸腔镜/肺叶切除术/前锯肌平面阻滞/艾司氯胺酮/镇痛/炎症反应Key words
Thoracoscopy/Lobectomy/Anterior serratus plane block Esketamine/Analgesia/Inflammatory response
