连续前锯肌平面阻滞联合患者自控静脉镇痛对胸腔镜肺叶切除术肺癌患者术后疼痛的影响

Effect of continuous serratus anterior plane block combined with patient-controlled intravenous analgesia on postoperative pain in patients with lung cancer undergoing thoracoscopic lobectomy

目的探讨连续前锯肌平面阻滞(serratus anterior plane block,SAPB)联合患者自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)对胸腔镜肺叶切除术肺癌患者术后疼痛的影响。方法选取2021年5月至2022年8月湖北医药学院附属人民医院收治的60例拟进行胸腔镜肺叶切除术肺癌患者为研究对象,采用随机数字表法分为研究组和常规组,每组30例。常规组给予PCIA,研究组给予连续SAPB联合PCIA。比较分析两组患者的手术情况、术后不同时间点的疼痛程度、术后不良反应发生情况以及术后肺部并发症发生情况。结果研究组患者的麻醉苏醒时间显著短于常规组(P<0.05)。术后2、4、8、12、24h,研究组患者静息状态及咳嗽状态下的视觉模拟评分法评分均显著低于常规组(P<0.05)。研究组患者的术后呼吸抑制发生率以及肺部并发症总发生率均显著低于常规组(P<0.05)。结论连续SAPB联合PCIA应用于胸腔镜肺叶切除术肺癌患者中可显著缩短麻醉苏醒时间,缓解术后早期疼痛,且安全性高,值得临床应用。

Objective To investigate the effect of continuous serratus anterior plane block(SAPB)combined with patient-controlled intravenous analgesia(PCIA)on postoperative pain in patients with lung cancer undergoing thoracoscopic lobectomy.Method Sixty patients with lung cancer who underwent thoracoscopic lobectomy in the People’s Hospital Affiliated to Hubei University of Medicine from May 2021 to August 2022 were selected as the study objects.They were divided into study group and routine group by random number table method,with 30 cases in each group.The routine group was given PCIA,and the study group was given continuous SAPB combined with PCIA.The operation conditions,pain degree at different time points after surgey,postoperative adverse reactions and postoperative pulmonary complications were compared between the two groups.Result The recovery time of anesthesia in the study group was significantly shorter than that in the routine group(P<0.05).At 2,4,8,12 and 24h after surgery,the VAS scores of resting state and cough in the study group were significantly lower than those in the routine group(P<0.05).The incidence of postoperative respiratory depression and the total incidence of pulmonary complications in the study group were significantly lower than those in the routine group(P<0.05).Conclusion The application of continuous SAPB combined with PCIA in patients with lung cancer undergoing thoracoscopic lobectomy can significantly shorten the anesthesia recovery time,relieve early postoperative pain,and has high degree of safety,which is worthy of clinical promotion.