Effect of Ultrasound-guided Serratus Anterior Plane Block Combined with Rectus Sheath Block on Postoperative Pain and Safety in Patients Undergoing Hepatobiliary Surgery
Objective:To investigate the influence of ultrasus-guided serratus anterior plane block(SAPB)combined with rectus sheath block(RSB)on postoperative pain and safety in patients undergoing hepatobiliary surgery.Method:A total of 118 patients with hepatobiliary surgery admitted to Fengcheng City People's Hospital from December 2019 to December 2022 were selected and divided into ST group and SR group according to random drawing method,with 59 cases each.SAPB and transverse abdominal plane block(TAPB)were used in ST group,and SAPB and RSB were used in SR group.Visual analogue scale(VAS)score at 2,6,12,24 and 48 h after surgery,nerve block operation time and onset time were compared between the two groups,and the operation time,intraoperative blood loss,first postoperative exhalation time,postoperative activity time,number of analgesic pump compression 48 h after surgery,Sufentanil dosage,rate of relief analgesia and length of hospital stay in the two groups were analyzed.The levels of serum cortisol(Cor)and norepinephrine(NE)were detected before surgery and 12,24 and 48 h after surgery,and the adverse reactions of the two groups were recorded.Result:VAS scores of 2,6,12,24 and 48 h in SR group were lower than those in ST group,the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of nerve block operation time,onset time,operation time,and intraoperative bleeding volume(P>0.05).The rescue analgesia rate in the SR group was 11.86%,there was no statistically significant difference compared to 15.25%in the ST group(P>0.05).The times of analgesic pump and Sufentanil dosage in SR group were less than those in the ST group,and the time of getting out of bed after surgery was earlier than that in ST group,the differences were statistically significant(P<0.05).Serum Cor and NE levels in SR group at 12,24 and 48 h after surgery were lower than those in ST group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidence of nausea,vomiting,respiratory depression,drowsiness,and hypoxemia between the SR group and the ST group(P>0.05).Conclusion:Compared with SAPB combined with TAPB,SAPB combined with RSB has better analgesic effect in hepatobiliary surgery,which can further relieve postoperative pain,reduce the dosage of sufentanil and the number of analgesic pump presses,alleviate stress reaction,shorten postoperative activity time,and use it safely without increasing the risk of adverse reactions.
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