前锯肌阻滞复合非插管全麻对胸腔镜手术患者早期康复质量的影响

Effect of serratus plane block combined with non-intubated general anesthesia on the early rehabilitation quality of thoracoscopy surgery

目的探讨前锯肌阻滞复合非插管全麻的胸腔镜手术患者术后早期康复质量。方法选择60例行胸腔镜肺楔形切除术患者,随机分为观察组和对照组。对照组实施常规双腔气管插管全麻,观察组采用超声引导下前锯肌阻滞辅助少量镇静镇痛药物保留自主呼吸非插管全麻。观察术后1 d和2 d的40项恢复质量评分量表(QoR-40)评分,并记录麻醉复苏时间、下地时间、住院时间、术后不良反应、满意度。结果术后1 d、2 d,观察组QoR-40总评分高于对照组(t分别=21.73、24.26,P均<0.05);观察组术后苏醒时间、住院时间、下地时间、咽喉痛和恶心呕吐发生率低于对照组,差异均有统计学意义(t分别=-13.09、-18.84、-17.70,χ^(2)分别=40.00、9.02,P均<0.05),观察组住院满意度评分高于对照组(t=10.37,P<0.05)。结论超声引导下前锯肌阻滞复合非气管插管全麻,可显著改善胸腔镜手术患者术后QoR-40评分,减少并发症,有利于患者早期康复。

Objective To investigate the early rehabilitation quality in the thoracoscopic surgery patients using serratus plane block combined with non-intubated general anesthesia.Methods A total of 60 patients undergoing video-assisted thoracoscopy pulmonary wedge resection were selected and divided into two groups,with 30 patients in each.The control group received general anesthesia with double lumen intubation,and the observation group received ultrasound-guided serratus plane block combined with non-intubated general anesthesia under spontaneous respiration.The QoR-40 score was observed at 1 and 2 days after operation,and the anesthesia recovery time,off-bed ambulation time,hospital stay,postoperative adverse reactions and satisfaction were recorded.Results The total score of QoR-40 in the observation group was higher than that in the control group at 1 and 2 days after operation(t=21.73,24.26,P<0.05).The postoperative recovery time,hospital stay,off-bed ambulation time,the incidence of sore throat,nausea and vomiting in the observation group were lower than those in the control group,and the difference was statistically significant(t=-13.09,-18.84,-17.70,χ^(2)=40.00,9.02,P<0.05).The inpatient satisfaction of the observation group was higher than that of the control group(t=10.37,P<0.05).Conclusion Serratus plane block combined with non-intubated general anesthesia can significantly improve the QoR-40 score of patients undergoing thoracoscopic surgery and reduce complications,which can improve early rehabilitation.