Effects of continuous rhomboid intercostal block on postoperative analgesia in patients undergoing thoracoscopic lobectomy
Objective To evaluate the effects of continuous rhomboid intercostal block(RIB)on postoperative analgesia in patients undergoing thoracoscopic lobectomy.Methods Sixty patients with American Society of Anesthesiologists(ASA)physical status ⅠorⅡ who were scheduled for thoracoscopic lobectomy between October 2020 and May 2021 were randomly allocated into continuous RIB group and patient-controlled intravenous analgesia(PCIA)group,with 30 patients in each group.Patients in continuous RIB group received ultrasound-guided RIB and tube placement before induction of general anesthesia,followed by continuous RIB analgesia after surgery.In PCIA group,no block interventions were performed and all patients received sufentanil PCIA after surgery.The sensory plane of continuous RIB group was recorded 30 min after RIB treatment.Visual analogue scale(VAS)score of pain at rest and cough at 1 h,6 h,12 h,24 h,and 48 h after operation were recorded.QoR-40 scale scores were recorded before surgery,and 24 h and 48 h after surgery.The intraoperative dosage of propofol and remifentanil were recorded.The dosage of rescue analgesic drugs(bucinnazine)and the number of rescue analgesia within 48 h postoperatively,as well as the incidence of adverse reactions,extubation time and postoperative hospital stay were also recorded.The degree of patient's satisfaction was assessed at 48 h postoperatively.Results One participant in the continuous RIB group and three participants in the PCIA group were excluded from this study.The VAS score of pain at rest and cough in the continuous RIB group were significantly lower than that in the PCIA group at each time point after surgery(all P＜0.01).There were no significant differences in the total score of QoR-40 scale or each item score before surgery between the two groups(all P＞0.05).At 24 h after surgery,the total score of QoR-40 scale and scores for physical comfort,emotional state,self-care ability,and pain control in the continuous RIB group were significantly higher than those in the PCIA group(all P＜0.01 or 0.05).At 48 h after surgery,the total score of QoR-40 scale and the scores for physical comfort,emotional state and pain control in the continuous RIB group were significantly higher than those in the PCIA group(all P＜0.01 or 0.05).There was no significant difference in the intraoperative dosage of propofol between the two groups(P＞0.05).The intraoperative dosage of remifentanil,the postoperative dosage of bucinnazine,and the proportion of patients receiving postoperative rescue analgesia in the continuous RIB group were significantly lower than those in the PCIA group(all P＜0.05).The continuous RIB group had lower incidence of nausea and vomiting than the PCIA group(all P＜0.05).There was no significant difference in the incidence of pruritus,drowsiness or dizziness between the two groups(all P＞0.05).There was no significant difference in the extubation time or the length of postoperative hospital stay between the two groups(both P＞0.05).The continuous RIB group had higher satisfaction scores than the PCIA group(P＜0.05).Conclusion Compared with PCIA,continuous RIB can provide better postoperative analgesia,reduce postoperative adverse reactions,and improve short-term recovery quality and the prognosis of patients undergoing thoracoscopic lobectomy.
万方数据
维普
