[目的]探究超声引导浅层胸骨旁肋间平面阻滞对胸骨切开心脏手术患者术后恢复质量和镇痛效果的影响.[方法]本研究共纳入64例胸骨切开心脏手术患者,随机分为接受浅层胸骨旁肋间平面阻滞使用罗哌卡因(罗哌卡因组)或生理盐水(生理盐水组)两组.主要研究指标为患者术后24 h恢复质量评分(QoR-15评分),其次为术后 24 h疼痛评分和阿片药物使用情况.[结果]与生理盐水组比较,罗哌卡因组术后 24 h QoR-15 评分显著提高[(89.60±13.24)vs(81.18±12.78),P=0.012],静息数字疼痛评分显著降低[(3.03±0.72)vs(4.26±0.93),P<0.001],咳嗽数字疼痛评分显著降低[(4.40±0.89)vs(5.44±1.05),P<0.001].同时,罗哌卡因组患者术后24 h阿片药物使用总量明显减少[14.15(4.95～30.00)mg vs 40.50(19.25～68.18)mg,P=0.002],补救镇痛需求亦明显减少[0.00(0.00～0.00)mg vs 0.00(0.00～100.00)mg,P=0.007].[结论]超声引导浅层胸骨旁肋间平面阻滞可通过提升术后镇痛效果及减少阿片药物使用量,提高胸骨切开心脏手术患者术后24 h的总体恢复质量,利于术后早期康复.
Effect of Ultrasound-guided Superficial Parasternal Intercostal Plane Block on The Quality of Recovery in Patients Undergoing Sternotomy Cardiac Surgery
[Objective]This study aims to explore the effect of ultrasound-guided superficial parasternal intercostal plane block on the quality of recovery and postoperative analgesia in patients undergoing sternotomy cardiac surgery.[Meth-ods]A total of 64 patients undergoing sternotomy cardiac surgery were selected for this study.They were randomly divided into two groups:one group received a superficial parasternal intercostal plane block with ropivacaine(the ropivacaine group),while the other was given normal saline(the normal saline group).The primary outcome was the Quality of Recov-ery-15(QoR-15)score on postoperative day 1 in both groups,accompanied by a comparative analysis of the pain score and opioid usage.[Results]Compared with the normal saline group,the ropivacaine group exhibited a significantly higher QoR-15 score on postoperative day 1[(89.60±13.24)vs(81.18±12.78),P=0.012].The numerical rating scale at rest was significantly lower[(3.03±0.72)vs(4.26±0.93),P<0.001],and the numerical rating scale during coughing was also sig-nificantly reduced[(4.40±0.89)vs(5.44±1.05),P<0.001].Concurrently,the cumulative morphine equivalent consump-tion during the initial 24 h postoperatively was significantly lower in patients who were administered the ropivacaine[14.15(4.95～30.00)mg vs 40.50(19.25～68.18)mg,P=0.002],and there was also a notable decrease in the rescue analgesia[0.00(0.00～0.00)mg vs 0.00(0.00～100.00)mg,P=0.007].[Conclusion]Ultrasound-guided superficial parasternal intercostal plane block can significantly enhance the overall quality of recovery in patients undergoing sternotomy cardiac surgery on postoperative day 1.The technique contributes to improved postoperative analgesic effects and a reduction in opioid usage,thereby facilitating early postoperative recovery.
quality of recoverysternotomy cardiac surgerysuperficial parasternal intercostal plane blockropiva-cainepostoperative analgesia
万方数据
维普
