超声引导下前锯肌平面阻滞与肋间神经阻滞对胸腔镜辅助开胸手术术后患者恢复的影响  

Impacts of ultrasound-guided serratus anterior plane block and intercostal nerve block on patients’recovery after video-assisted thoracoscopic surery

作　　者：林嘉莹 钟国城 刘凯星 邱柳基 麦婧雯 段坦炎 罗德兴[1] LIN Jiaying;ZHONG Guocheng;LIU Kaixing;QIU Liuji;MAI Jingwen;DUAN Tanyan;LUO Dexing(Department of Anesthesiology,Huizhou Central People’s Hospital,Guangdong,Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院麻醉科,广东惠州516001

出　　处：《中国医药科学》2025年第3期164-167,共4页China Medicine And Pharmacy

基　　金：广东省惠州市科技计划项目(221014146940807)。

摘　　要：目的 探讨前锯肌平面阻滞与肋间神经阻滞对胸腔镜辅助开胸手术术后患者恢复的影响。方法 选择2022年7月至2023年4月在广东省惠州市中心人民医院首次行胸腔镜辅助开胸手术的患者150例,根据随机数表法分为两组,前锯肌平面阻滞联合静吸复合全麻组(SG组)和肋间神经联合静吸复合全麻组(IG组)。比较两组患者围手术期镇痛镇静药使用量、慢性疼痛发生率、术后视觉模拟评分(VAS)及40项恢复质量评分量表(QoR-40)评分差异。结果 SG组术中丙泊酚、瑞芬太尼及术后镇痛药使用量低于IG组,差异有统计学意义(P <0.05)。SG组术后6、12、24 h安静状态时及术后6、12、24、48 h活动时VAS评分低于IG组,差异有统计学意义(P <0.05)。SG组QoR-40评分高于IG组,差异有统计学意义(P <0.05)。结论 超声引导下前锯肌平面阻滞安全可靠有效,显著减少围手术期镇静镇痛药的使用,降低患者术后6~24 h后静息和活动后疼痛程度,降低慢性疼痛发生率。Objective To investigate the impacts of serratus anterior plane block and intercostal nerve block on patients’recovery after video-assisted thoracoscopic surery.Methods A total of 150 patients undergoing video-assisted thoracoscopic surery for the first time and admitted to Huizhou Central People’s Hospital from July 2022 to April 2023 were selected.They were divi ded into t he group of serrat us anterior plane block combined with static aspiration composite general anesthesia(the SG group)and the group of intercostal nerve block combined with static aspiration combined general anesthesia(the IG group)according to the random number table method.The perioperative analgesic and sedative dosage,the incidence of chronic pain,postoperative visual analogue scale(VAS)and 40 items of quality of recovery scale(QoR-40)were compared between the two groups of patients.Results The usage of propofol,remifentanil and postoperative analgesics in the SG group was lower than that in the IG group,with statistically significant differences(P<0.05).At 6,12 and 24 hours after operation during rest,and at 6,12,24 and 48 hours after operation during exercise,the VAS score in the SG group was lower than that in the IG group,with statistically significant difference(P<0.05).The QoR-40 score of the SG group was higher than that of the IG group,with statistically significant difference(P<0.05).Conclusion Ultrasound-guided serratus anterior plane block is safe,reliable and effective,which can significantly reduce the use of sedatives and analgesics during perioperative period,reduce the degree of pain after 6-24 hours after surgery and reduce the incidence of chronic pain.

关 键 词：胸腔镜辅助开胸手术 前锯肌平面阻滞 肋间神经阻滞 慢性疼痛 

分 类 号：R614.4[医药卫生—麻醉学]