摘要
目的验证菱形肌-肋间肌-低位前锯肌平面阻滞对胸腔镜下肺癌根治术患者术后早期恢复质量的改善作用;比较不同阻滞时机改善术后早期恢复质量的差异性。方法选取2022年1月至2023年1月拟行胸腔镜下肺癌根治术患者共75例,年龄18~75岁,美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ~Ⅱ级。随机分为3组:空白对照组(C组)、术前阻滞组(PR组)、术后阻滞组(PO组)。PR组与PO组分别在术前及术后接受超声引导下菱形-肋间-低位前锯肌平面阻滞,药物为0.375%罗哌卡因共30ml。通过术后恢复质量评分量表(postoperative recovery quality rating scale,QoR-40)评价患者术后24h、48h恢复质量;记录术后0.5、1、2、4、8、12、24、48h静息及活动状态数字疼痛评分(numeric rating scale,NRS)疼痛评分;记录术中及术后阿片类药物的消耗量、术后自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)有效按压次数及恶心、呕吐发生率。结果与C组比较,PR组术中阿片类药物消耗量明显减少,PR组及PO组术后24h QoR-40得分更高,术后1~8h静息状态与1~12h活动状态NRS评分明显降低,PCIA有效按压次数及阿片类药物消耗量明显减少(P<0.05);与PR组比较,PO组术中阿片类药物消耗更多,术后0.5hNRS评分更高(P<0.05);术后Qo R-40得分、PCIA有效按压次数、阿片类药物消耗量差异无统计学意义(P>0.05);3组术后恶心、呕吐发生率差异无统计学意义(P>0.05)。结论菱形肌-肋间肌-低位前锯肌平面阻滞能改善胸腔镜下肺癌根治术患者术后早期恢复质量,减轻患者术后疼痛程度,减少围术期阿片类药物用药量,且其有效性与阻滞时机无关。
Objective Verify the improvement effect of rhomboid intercostal and sub-serratus plane block on the quality of early postoperative recovery in patients undergoing thoracoscopic radical resection of lung cancer;Comparison of the differences in the effect of regional block at different timing on improving the quality of early postoperative recovery.Methods A total of 75 patients,aged 18 to 75 years,with ASA grade I-II,who were scheduled to undergo thoracoscopic radical resection of lung cancer from January 2022 to January 2023 were selected.Randomly divided into three groups:blank control group(Group C),preoperative block group(PR group),and postoperative block group(PO group).The PR group and the PO group received ultrasound guided rhomboid intercostal and sub-serratus plane block in the preoperative anesthesia preparation room and postoperative anesthesia recovery room,respectively,with a dosage of 0.375% ropivacaine 30ml.Evaluate the postoperative recovery quality of patients at 24 and 48 hours using the postoperative recovery quality rating scale(QoR-40)scoring scale.Record numeric rating scale(NRS)pain scores in resting and active states at 0.5h,1h,2h,4h,8h,12h,24h,and 48h after surgery.Record the consumption of opioid drugs during and after surgery,the effective number of postoperative patient-controlled intravenous analgesia(PCIA)compressions,and the incidence of nausea and vomiting.Results Compared with Group C,the consumption of opioids during surgery in the PR group was significantly reduced.The QoR-40 score at 24 hours after surgery was significantly higher in the PR and PO groups.Significant reduction in NRS scores between 1-8 hours of rest and 1-12 hours of activity after surgery,and the effective times of PCIA compressions and opioid consumption were significantly reduced(P<0.05).Compared with the PR group,the PO group consumed more opioids during surgery and had a higher NRS score at 0.5 hours after surgery(P<0.05).There was no significant difference in postoperative QoR-40 scores,PCIA effective comp
作者
郝倩
代红雨
李春艳
周红梅
朱志鹏
HAO Qian;DAI Hongyu;LI Chunyan;ZHOU Hongmei;ZHU Zhipeng(Department of Anesthesiology,the Second Hospital of Jiaxing,Jiaxing 314000,Zhejiang,China)
出处
《中国现代医生》
2024年第8期25-29,共5页
China Modern Doctor
基金
浙江省嘉兴市科技计划项目(2021AD30083)。
关键词
区域平面阻滞
菱形-肋间-低位前锯肌阻滞
胸腔镜手术
肺癌根治术
Regional plane block
Rhomboid intercostal and sub-serratus plane block
Video-assisted thoracic surgery
Radical resection of pulmonary carcinoma
