Objective To observe the effect of rhomboid-intercostal and sub-serratus plane block(RISS)on the quality of recovery postoperatively in patients undergoing video-assisted thoracic surgery.Methods Sixty-four patients undergoing video-assisted thoracic surgery were randomly divided into RISS group(group R)and intercostal nerve block group(group I),32 cases for each group.Patients in group R received ultrasound-guided RISS block with 40 mL of 0.5%ropivacaine before anesthesia induction.While patients in group I received intercostal nerve block under thoracoscopic direct vision before closing the chest,and 5 mL of 0.5%ropivacaine was injected into each target intercostal space.All patients were given patient-controlled intravenous analgesia(PCIA)postoperatively.The block range of patients in group R was measured 20 min after injection.The quality of recovery(QoR-15)scores of the two groups were recorded at 24 h and 48 h after operation.The visual analogue scale(VAS)scores at rest and cough were recorded at 15 min after extubation,at the time of discharging from post anesthesia care unit,and at 4 h,6 h,24 h and 48 h after operation.The time of first pressing PCIA,the times of effective pressing PCIA and intravenous rescue analgesic and the anesthesia-related complications within 48 h after operation were recorded.Results The block range of RISS was from T3 to T10 level.At the T3-T9 level,the block range extended from the midclavicular line of the anterior chest wall to the scapular line of the posterior chest wall.At the T10 level,it extended from the anterior axillary line to the posterior axillary line.The QoR-15 scores of group R at 24 h and 48 h after operation were higher than that of group I(both P<0.05).The VAS scores at rest and coughing of group R were lower than those of group I at 5 min after extubation and the time of discharging from post anesthesia care unit,and the VAS scores at rest of group R were lower than those of group I at 4 h and 6 h after operation(both P<0.05).There was no significant difference in VAS score at other time points(P>0.05).Compared with group I,the time of first pressing PICA was more later in group R(P<0.05).While there was no significant difference in the times of effective pressing PCIA and intravenous rescue analgesic and the complications within 48 h after operation between the two groups.(P>0.05).Conclusion Compared with intercostal nerve block,ultrasound-guided RISS block can provide perfect perioperative analgesic effect for patients undergoing video-assisted thoracic surgery,alleviate early postoperative pain and improve the quality of recovery postoperatively.
Ultrasound-guidedNerve blockRhomboid intercostal and sub-serratus plane blockVideo-assisted thoracic surgeryThe quality of recovery postoperatively
万方数据
维普
