Comparison of the application of parasternal pectoralis major intercostal plane block and erector spinae plane block in cardiac surgery
Objective To evaluate the safety and effectiveness of pecto-intercostal fascial plane(PIFP)block and erector spinae plane(ESP)block for postoperative analgesia in median open heart surgery.Methods A total of 158 patients who underwent elective midline open heart surgery at the Nanjing First Hospital,Nanjing Medical University from October 2022 to October 2023 were randomly divided into a PIFP block group(P group)and ESP block group(E group)using a random number table method,with 79 patients in each group.Before anesthesia surgery,the group P underwent ultrasound-guided bilateral PIFP block,while the group E underwent ultrasound-guided bilateral ESP block.Both groups received sufentanil intravenous patient-controlled analgesia after surgery.The resting and activity Visual Analog Scale(VAS)scores of two groups of patients at 6,12,18,and 24 hours after surgery were recorded;The first press time of the patient's postoperative patient-controlled analgesia pump,the cumulative dose of sufentanil within 24 hours,the number of effective presses,and the rate of salvage analgesia were recorded;and extubation time,intensive care unit(ICU)stay,and adverse reactions;the time of nerve block operation,clarity score of puncture needle imaging under ultrasound,and patient satisfaction with nerve block were also recorded.Results There was no statistically significant difference in resting VAS scores and activity VAS scores between the two groups at 6,12,18,and 24 hours after surgery(all P＞0.05).The activity VAS scores of the group P were lower than those of the group E at 6 and 12 hours after surgery(all P＜0.05);Compared with the group E,patients in the group P had significantly longer first press time of postoperative analgesia pump(all P＜0.05),lower salvage analgesia rate,cumulative dose of sufentanil 24 hours after surgery,and fewer effective presses of analgesia pump(all P＜0.05);There was no statistically significant difference in extubation time,ICU stay,and incidence rate of nausea between the two groups of patients(all P＞0.05);Compared with the group E,the group P had shorter nerve block operation time,higher clarity score of puncture needle imaging under ultrasound,and higher patient satisfaction(all P＜0.05).Conclusions Compared with ESP block,PIFP block can provide better perioperative analgesia for cardiac surgery patients,reduce the use of opioid drugs,and the operation of PIFP block is simpler,with good safety and effectiveness.
万方数据
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