单孔电视胸腔镜手术患者的浅、深锯肌前平面阻滞镇痛：一项随机前瞻性试验

IF 5.1 2区医学 Q1 ANESTHESIOLOGY

Journal of Clinical Anesthesia Pub Date : 2025-07-31 DOI:10.1016/j.jclinane.2025.111950

Gaige Meng, Wen Chen, Dewen Shi, Bin Mei, Xuesheng Liu

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引用次数: 0

摘要

研究目的胸外科术后疼痛严重，前锯肌阻滞（SAPB）被广泛应用于胸外科患者的围手术期镇痛。在前锯肌表面注射的局部麻醉剂称为浅SAPB (SSAPB)，而在深层表面注射的局部麻醉剂称为深SAPB （DSAPB）。我们观察了两种SAPB变体（浅表和深层）对接受单孔电视胸腔镜手术（VATS）的患者的镇痛效果的差异。设计一项随机前瞻性试验。单机院校教学医院。80例患者在全身麻醉下行单孔VATS。80例接受单端口VATS的患者随机分为S组（接受SSAPB的患者）和D组（接受DSAPB的患者）。主要指标是术后24小时内阿片类药物的消耗。次要结局是术前、术后立即、术后6、12和24小时休息和咳嗽时的疼痛评分。主要结果术后24 h内，S组患者阿片类药物总消耗量低于D组（P = 0.001）。S组患者术后6 h休息或咳嗽时疼痛评分低于D组（P = 0.000, P = 0.000）。术后12 h S组咳嗽疼痛评分低于D组（P = 0.000），两组术后其他时间点疼痛评分差异无统计学意义。结论对于接受单孔VATS肺叶切除术的患者，与DSAPB相比，SSAPB与阿片类药物消耗减少和疼痛评分降低有关。

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Superficial vs. deep serratus anterior plane block for analgesia in patients undergoing single-port video-assisted thoracoscopic surgery: A randomized prospective trial

Study objective

Postoperative pain following thoracic surgery is often severe, and serratus anterior plane block (SAPB) is widely used for perioperative analgesia in such patients. Local anesthetics injected on the surface of the serratus anterior muscle are called superficial SAPB (SSAPB), while those injected on the deep surface are called deep SAPB (DSAPB). We observed the differences in analgesic effects of two variants of SAPB (superficial and deep) on patients receiving single-port video-assisted thoracoscopic surgery (VATS).

Design

A randomized prospective trial.

Setting

Single university teaching hospital.

Patients

Eighty patients who underwent single-port VATS under general anesthesia.

Interventions

Eighty patients who received single-port VATS were randomly assigned to Group S (patients who received SSAPB) and Group D (patients who received DSAPB).

Measurements

The primary outcome was opioid consumption within 24 h after surgery. Secondary outcomes were pain scores at rest and on coughing before surgery, immediately after surgery, 6, 12, and 24 h after surgery.

Main results

Within 24 h after surgery, the total opioid consumption of patients in Group S was lower than that of patients in Group D (P = 0.001). The pain scores of patients in Group S were lower than those in Group D at rest or coughing 6 h after surgery (P = 0.000, P = 0.000). The pain score on coughing in Group S was lower than that in Group D at 12 h after surgery (P = 0.000), and there was no difference in postoperative pain scores between the two groups at other time points.

Conclusion

For patients undergoing single-port VATS lobectomy, SSAPB was associated with reduced opioid consumption and lower pain scores compared to DSAPB.

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来源期刊

Journal of Clinical Anesthesia 医学-麻醉学

CiteScore

7.40

自引率

4.50%

发文量

346

审稿时长

23 days

期刊介绍： The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.