Effect of pectointercostal fascial block on early postoperative quality of recovery in patients undergo-ing cardiac valve replacement
Objective To investigate the effect of ultrasound-guided pectointercostal fascial block(PIFB)on early postoperative quality of recovery in cardiac valve replacement.Methods Eighty patients,45 males and 35 females,aged 44-75 years,BMI 18-30 kg/m2,ASA physical status Ⅱ or Ⅲ,who un-derwent cardiac valve replacement through median sternotomy were randomly divided into two groups:general anesthesia combined with PIFB group(group P)and general anesthesia group(group C),40 pa-tients in each group.After anesthesia induction,the patients in group P underwent bilateral PIFB guided by ultrasound while group C was not subjected to block operation.The patients in both groups were routinely re-ceived sufentanil for patient-controlled intravenous analgesia(PCIA)after surgery.The 15-item quality of recovery(QoR-15)scale was used to assess the early postoperative quality of recovery at 24 hours before surgery and 24 and 72 hours after surgery.The HR and MAP were recorded before induction of anaesthesia,at the time of skin incision,sternum sawing,chest closure,and leaving the operating room.The visual ana-logue scale(VAS)pain scores of patients at rest and during activity(cough)at 4,8,and 12 hours after extubation,dosage of sufentanil during operation and 48 hours after operation were recorded,the extubation time,length of ICU,the first exhaust time,length of the postoperative hospital stay were recorded.The oc-currence of postoperative nausea and vomiting,hypotension,respiratory depression,mortality during hospi-talization and other adverse reactions were recorded.Results Compared with group C,the QoR-15 scores at 24 and 72 hours after surgery were increased,VAS pain scores at rest or during activity at each time point after extubation,the intraoperative and postoperative sufentanil dose were decreased,the extubation time,length of ICU,and the first exhaust time were shortened in group P(P＜0.05).The incidence of nausea and vomiting in group P was lower than that in group C(P＜0.05).HR and MAP at each time point,and hospital stay,mortality during hospitalization had no significant differences between the two groups.Conclusion PIFB can reduce postoperative pain,promote patient recovery and improve recovery quality in patients undergoing cardiac valve replacement using a median sternotomy approach.
Pectointercostal fascial blockCardiac valve replacementMedian sternotomyPost-operative quality of recovery
万方数据
维普
