超声引导低位前锯肌平面阻滞对腹腔镜胃癌根治术患者术后镇痛的影响
Effect of ultrasound-guided serratus anterior plane block on postoperative analgesia in patients undergoing laparoscopic radical gastrectomy
成忠平 1于凯丽 1王若 1王晓坤 1罗维昊 1尹毅青1
作者信息
- 1. 天津医科大学肿瘤医院麻醉科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床研究中心,天津市"肿瘤防治"重点实验室(天津市 300060)
- 折叠
摘要
目的:评价超声引导低位前锯肌平面阻滞对腹腔镜胃癌根治术患者术后镇痛效果的影响.方法:选取 2022年 5月至 2023年 10月在天津医科大学肿瘤医院择期全麻下行腹腔镜胃癌根治术患者 60例,按随机数字表法分为全身麻醉组(C组)和全身麻醉联合超声引导低位前锯肌平面阻滞(serratus anterior plane block,SAPB)组(S组).术毕均行舒芬太尼自控静脉镇痛泵,记录患者术后 1、6、12、24、48 h静息时视觉模拟评分(visual analogue scale,VAS),术后VAS≥4分时静脉注射舒芬太尼 0.1 μg/kg补救镇痛,记录镇痛泵有效按压次数、补救镇痛次数、术后首次排气时间、首次下床时间、首次进食时间和住院时长.结果:与C组比较,S组术后 1、6、12 h静息状态下VAS评分明显降低(P<0.05),S组术后镇痛泵有效按压次数、补救镇痛次数明显减少C组[(6.1±0.4)次 vs.(18.6±1.4)次,2次 vs.17次;P<0.001],术后首次排气时间、首次下床时间、首次进食时间和住院时间缩短(P<0.05).两组患者其余指标比较差异无统计学意义(P>0.05).结论:超声引导低位前锯肌平面阻滞可有效减轻腹腔镜胃癌根治术患者术后疼痛,有助于促进患者术后快速康复.
Abstract
Objective:To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia in patients un-dergoing laparoscopic radical gastrectomy.Methods:Sixty patients who underwent elective laparoscopic radical gastrectomy were enrolled between May 2022 and October 2023 at Tianjin Medical University Cancer Institute&Hospital.Patients were assigned into two groups us-ing a random number table method:the control(group C)and the ultrasound-guided serratus anterior plane block(SAPB)(group S).Patient-controlled intravenous analgesia(PCIA)was administered at the end of the surgery.After surgery,visual analogue scale(VAS)of static pain scores was evaluated at 1,6,12,24,and 48 hours.PCIA pump was started at the VAS pain score≥4 after surgery,and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA use,time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and the duration of hospitalization stay were recorded for the two groups.Results:VAS scores were significantly lower at postoperative 1,6,and 12 h in group S than in group C(P<0.05).Additionally,the number of effective uses of PCIA,and rescue analgesia were significantly lower in group S[(6.1±0.4)(2)]than in group C[(18.6±1.4)(17)](P<0.001).The time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and duration of hospital stay were shortened in group S than in group C(P<0.05).There were no significant differences in other parameters between these two groups.Conclusion:Ultrasound-guided SAPB can reduce postoperative pain and facilitate fast recovery in laparoscopic radical gastrectomy patients.
关键词
超声检查/前锯肌平面阻滞/胃癌/腹腔镜手术/术后镇痛Key words
ultrasonography/serratus anterior plane block(SAPB)/gastric cancer/laparoscopic operation/postoperative analgesia引用本文复制引用
基金项目
天津市医学重点学科(专科)建设项目(TJYXZDXK-009A)
出版年
2024
NETL
NSTL
万方数据