Effect of Ultrasound-Guided External Oblique Intercostal Block on Postoperative Recovery After Subxiphoid Video-Assisted Thoracoscopic Thymectomy

IF 2.1 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2024-10-03 DOI:10.1002/jum.16591

Zhiang Li MM, Lihong Hu MD, Yong Xi MD, Lingzhi Wang MM, Xuwei Zhang MM, Joseph Mugaanyi MD

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引用次数: 0

Abstract

Objective

Severe postoperative pain can occur after subxiphoid video-assisted thoracoscopic thymectomy (SVATT), affecting the quality of postoperative recovery. This study aimed to evaluate the effect of ultrasound-guided external oblique intercostal (EOI) block on recovery after SVATT.

Methods

A total of 60 patients undergoing SVATT were randomly divided into the EOI group (group E, n = 30) and the control group (group C, n = 30). Group E underwent ultrasound-guided bilateral EOI block at the 6th rib level and was injected 20 mL of 0.375% ropivacaine on each side. Group C was injected with 20 mL of 0.9% saline at the same site. After the operation, both groups received a patient-controlled intravenous analgesic (PCIA) pump. The 15-item Quality of Recovery (QoR-15) scores were recorded at 24 hours before surgery (T0), 24 hours after surgery (T3), and 48 hours after surgery (T4). The sufentanil usage in the first 24 hours postoperatively, the remifentanil dosage during surgery, the time of first pressing PCIA, and the cases of rescue analgesia were recorded. The visual analog scale (VAS) scores of patients at 6 (T1), 12 (T2), 24 (T3), and 48 hours (T4) after an operation during rest and coughing were recorded. The dermatomes of the sensory plane, block complications in group E, and the incidence of other postoperative adverse reactions in both groups were also recorded.

Results

Compared with group C, the QoR-15 scores of patients were significantly higher at T3 and T4 in the group E. The VAS scores were significantly lower at T1, T2, and T3 during rest and coughing in the group E. The sufentanil usage in the first 24 hours postoperatively, the remifentanil dosage during surgery, and the cases of rescue analgesia were significantly lower in group E, and the time of first pressing PCIA was significantly increased in group E (all P < .05).

Conclusion

Ultrasound-guided EOI block can be safely used in patients undergoing SVATT, which can improve the quality of postoperative recovery and reduce postoperative pain.

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超声引导下肋间外斜肌阻滞对剑突下视频辅助胸腔镜胸腺切除术后恢复的影响：随机对照试验

目的：剑突下视频辅助胸腔镜胸腺切除术（SVATT）术后可能出现剧烈疼痛，影响术后恢复质量。本研究旨在评估超声引导下肋间外斜肌阻滞对 SVATT 术后恢复的影响：共有 60 名接受 SVATT 的患者被随机分为 EOI 组（E 组，n = 30）和对照组（C 组，n = 30）。E 组在超声引导下在第 6 肋骨水平进行双侧 EOI 阻滞，每侧注射 20 毫升 0.375% 罗哌卡因。C 组在同一部位注射 20 mL 0.9% 生理盐水。手术后，两组患者都接受了患者自控静脉镇痛（PCIA）泵。在手术前 24 小时（T0）、手术后 24 小时（T3）和手术后 48 小时（T4）记录 15 项恢复质量（QoR-15）评分。记录了术后前 24 小时舒芬太尼的用量、术中瑞芬太尼的用量、首次按压 PCIA 的时间以及抢救性镇痛的情况。记录患者在术后 6 小时（T1）、12 小时（T2）、24 小时（T3）和 48 小时（T4）休息和咳嗽时的视觉模拟量表（VAS）评分。此外，还记录了两组患者的感觉平面皮膜、E组的阻滞并发症以及其他术后不良反应的发生率：与C组相比，E组患者在T3和T4时的QoR-15评分明显升高；E组患者在T1、T2和T3休息和咳嗽时的VAS评分明显降低；E组患者术后前24小时舒芬太尼用量、术中瑞芬太尼用量和抢救性镇痛例数明显降低，E组患者首次按压PCIA的时间明显延长（均为P 结论：超声引导下EO阻滞术是一种有效的术后镇痛方法：超声引导下 EOI 阻滞可安全用于 SVATT 患者，可提高术后恢复质量，减轻术后疼痛。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound