前锯肌平面阻滞复合全身麻醉对非小细胞肺癌胸腔镜肺叶切除术患者血流动力学指标及术后疼痛的影响  

Influence of anterior serratus plane block combined with general anesthesia on intraoperative hemodynamics and postoperative pain in patients with non-small cell lung cancer undergoing thoracoscopic lobectomy

作　　者：朱森 郑超 ZHU Sen;ZHENG Chao(Department of Anaesthesia,Shangqiu Third People’s Hospital,Shangqiu 476000,He’nan,China)

机构地区：[1]商丘市第三人民医院麻醉科,河南商丘4760000

出　　处：《癌症进展》2025年第9期1086-1089,共4页Oncology Progress

摘　　要：目的探讨前锯肌平面阻滞复合全身麻醉对非小细胞肺癌(NSCLC)胸腔镜肺叶切除术患者血流动力学指标及术后疼痛的影响。方法依据麻醉方式的不同将80例NSCLC胸腔镜肺叶切除术患者分为对照组(n=41)和观察组(n=39),观察组患者胸腔镜肺叶切除术中接受前锯肌平面阻滞复合全身麻醉,对照组患者胸腔镜肺叶切除术中接受全身麻醉。比较两组患者的血流动力学指标[平均动脉压(MAP)、心率]、术后疼痛程度[视觉模拟评分法(VAS)]、手术相关指标及并发症发生情况。结果插管后10 min(T_(2))~清醒拔管后5 min(T_(5)),观察组患者MAP、心率均低于对照组,差异均有统计学意义(P﹤0.05)。术后4、12、24、48 h,两组患者的VAS评分均呈先升高后降低趋势,且观察组患者的VAS评分均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者首次肛门排气时间、手术下床活动时间及气管插管拔管时间均短于对照组,差异均有统计学意义(P﹤0.05)。观察组患者恶心呕吐发生率低于对照组,差异有统计学意义(P﹤0.05)。结论NSCLC胸腔镜肺叶切除术患者行前锯肌平面阻滞复合全身麻醉可保持胸腔镜血流动力学稳定,减轻术后疼痛,还可促进患者的术后恢复,安全性较好。Objective To investigate the influence of anterior serratus plane block combined with general anesthesia on intraoperative hemodynamics and postoperative pain in patients with non-small cell lung cancer(NSCLC)undergoing thoracoscopic lobectomy.Method According to different anesthesia methods,80 patients with NSCLC undergoing thoracoscopic lobectomy were divided into control group(n=41)and observation group(n=39).Patients in the observation group received anterior serratus plane block combined with general anesthesia during thoracoscopic lobectomy,while patients in the control group received general anesthesia during thoracoscopic lobectomy.The hemodynamic indicators[mean arterial pressure(MAP),heart rate],postoperative pain level[visual analogue scale(VAS)],surgical related indicators,and incidence of complications were compared between the two groups.Result From 10 minutes after intubation(T_(2))to 5 minutes after conscious extubation(T_(5)),the MAP and heart rate in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).At 4,12,24,48 h after the operation,the VAS scores in both groups showed a trend of increasing first and then decreasing,and the VAS scores in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The first anal exhaust time,surgical mobilization time,and tracheal intubation and extubation time in observation group were shorter than those in control group,and the differences were statistically significant(P<0.05).The incidence of nausea and vomiting in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion Preoperative anterior serratus plane block combined with general anesthesia can maintain stable thoracoscopic hemodynamics,reduce postoperative pain,and promote postoperative recovery in patients with NSCLC undergoing thoracoscopic lobectomy,with good safety.

关 键 词：非小细胞肺癌 前锯肌平面阻滞 全身麻醉 血流动力学 疼痛 

分 类 号：R734.2[医药卫生—肿瘤]