超声引导下前锯肌平面阻滞在经右侧开胸纵隔肿瘤切除手术中的应用效果  

Application effect of ultrasound-guided serratus anterior plane block in the resection of mediastinal tumors through right thoracotomy

作　　者：袁磊 曾建强 黄金华 YUAN Lei;ZENG Jianqiang;HUANG Jinhua(Department of Anesthesiology,Ganzhou Cancer Hospital,Jiangxi Province,Ganzhou,341000,China)

机构地区：[1]江西省赣州市肿瘤医院麻醉科,江西赣州341000

出　　处：《中国当代医药》2022年第22期106-109,共4页China Modern Medicine

基　　金：江西省赣州市卫生健康委员会市级科研计划项目(2022-2-096)。

摘　　要：目的探讨超声引导下前锯肌平面阻滞(SAPB)在经右侧开胸单肺通气下纵隔肿瘤切除手术中的应用效果。方法选取2020年1月至2021年12月赣州市肿瘤医院收治的40例全麻下经右侧开胸单肺通气下纵隔肿瘤切除手术患者作为研究对象,采用随机数字表法将其分为SAPB(S组)和胸段硬膜外阻滞组(E组),每组各20例。S组患者在全麻双腔支气管插管后行左侧卧位,再行超声引导下前锯肌深层平面阻滞。E组患者在麻醉诱导前行胸段硬膜外穿刺并置管。比较两者患者入室时(T_(1))、开胸前5 min(T_(2))、开胸后5 min(T_(3))的心率(HR)、平均动脉压(MAP),比较两组术后4、8、12 h的视觉模拟评分法(VAS)评分。结果T_(2)、T_(3)时E组患者MAP及HR低于S组,差异有统计学意义(P<0.05)。E组患者术后4、8 h的VAS评分低于S组,差异有统计学意义(P<0.05)。结论超声引导下SAPB在经右侧开胸纵隔肿瘤切除术后较胸段硬膜外阻滞术后镇痛效果相当,但超声引导下SAPB可更好地稳定术中患者生命体征,值得临床开展应用。Objective To explore the application effect of ultrasound-guided serratus anterior plane block(SAPB)in mediastinal tumor resection with right thoracotomy and single lung ventilation.Methods A total of 40 patients with mediastinal tumor resection under general anesthesia through right thoracotomy and one-lung ventilation who were admitted to Ganzhou Cancer Hospital from January 2020 to December 2021 were selected as the research subjects,and they were divided into SAPB group(group S)and thoracic epidural block group(group E)using random number table method,with 20 cases in each group.Group S underwent the left lateral decubitus position after double-lumen bronchial intubation under general anesthesia,followed by ultrasound-guided anterior serratus muscle deep plane block.Group E had anterior thoracic epidural puncture and catheterization before anesthesia.The heart rate(HR)and mean arterial pressure(MAP)at entry(T_(1)),5 min after thoracotomy(T_(2))and 5 min after thoracotomy(T_(3))were compared between the two groups.The visual analogue scale(VAS)score at 4,8 and 12 h after thoracotomy were compared between the two groups.Results At T_(2) and T_(3),the levels of MAP and HR in group E were lower than those in group S,with statistical significances(P<0.05).The VAS score at 4 and 8 h after surgery in group E were lower than those in group S,with statistical significances(P<0.05).Conclusion Ultrasound-guided SAPB has the same analgesic effect as thoracic epidural block after mediastinal tumor resection through right thoracotomy,but ultrasound-guided SAPB can better stabilize patients′vital signs during surgery,which is worthy of clinical application.

关 键 词：超声引导 前锯肌平面阻滞 经右侧开胸 纵隔肿瘤切除术 

分 类 号：R614[医药卫生—麻醉学]