Optimizing anesthesia for thoracoscopic surgical ablation of atrial fibrillation:efficacy of serratus anterior plane block combined with general anesthesia
Optimizing anesthesia for thoracoscopic surgical ablation of atrial fibrillation:efficacy of serratus anterior plane block combined with general anesthesia
Objective To evaluate the optimization effects of serratus anterior plane block(SAPB)combined with general anesthesia for thoracoscopic surgical ablation of atrial fibrillation(TSAAF).Methods Eighty American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex,aged＞18 yr,with a body mass index of 18-30 kg/m2,scheduled for elective TSAAF,were randomly as-signed to either SAPB combined with general anesthesia group(SG group)or general anesthesia group(G group),with 40 cases in each group.SG group received ultrasound-guided bilateral SAPB with 0.375％ rop-ivacaine 20 ml each before surgery,while G group did not receive block before operation.Both groups un-derwent general anesthesia.The time to the first analgesia pump use,the number of successfully delivered doses and requirement for rescue analgesia within 48 h after operation were recorded.Inspiratory spirometry was measured at preoperative day 1(T0),at the time of discharge from the recovery room(T,),and at 24 and 48 h after operation(T2.3).The extubation time was also recorded.The usage of intraoperative remifen-tanil,norepinephrine and ephedrine,duration of recovery room stay,and occurrence of recurrent atrial fi-brillation,delirium,respiratory depression,and nausea/vomiting within 48 h after operation,and length of postoperative hospital stay were recorded.Results Compared to G group,the time to the first analgesia pump use was significantly prolonged,the number of successfully delivered doses was reduced within 48 h after operation,the rate of rescue analgesia was decreased,inspiratory spirometry was increased at T1-3,the extubation time and length of postoperative hospital stay were shortened,and the recurrence rate of atrial fi-brillation was decreased within 48 h after surgery in SG group(P＜0.05).No significant differences were found between the two groups regarding the intraoperative remifentanil consumption,usage rate of vasoactive drugs,and incidence of postoperative nausea/vomiting,delirium and respiratory depression(P＞0.05).Conclusions Combination of SAPB and general anesthesia can effectively improve the postoperative anal-gesic effect and is helpful for the recovery in the patients undergoing TSAAF.
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