超声引导前锯肌阻滞在胸腔镜肺癌手术麻醉及术后镇痛中的应用效果分析

Analysis of the Effect of Ultrasound-guided Anterior Serratus Block in Thoracoscopic Lung Cancer Surgery Anesthesia and Postoperative Analgesia

目的探讨超声引导前锯肌阻滞在胸腔镜肺癌手术麻醉中的应用效果及术后镇痛作用。方法选择2020年5月—2022年4月扬州市江都人民医院收治的80例胸腔镜肺癌手术患者,随机分为对照组(n=40,常规静吸复合麻醉)与观察组(n=40,联合超声引导前锯肌阻滞)。比较两组术中平均动脉压与心率、术后VAS评分、麻醉药物用量及镇痛泵使用情况。结果观察组切皮时心率(82.17±5.72)次/min、平均动脉压(93.12±6.84)mmHg均低于对照组,差异有统计学意义(t=8.473、3.759,P<0.05)。观察组术后4、12 h静息VAS评分(0.93±0.34)分、(1.26±0.45)分及活动VAS评分(1.52±0.60)分、(2.24±0.56)分均低于对照组,差异有统计学意义(t=14.669、10.488、13.617、9.613,P<0.05)。观察组舒芬太尼、瑞芬太尼用量及镇痛泵按压次数分别为(38.44±5.02)μg、(1004.13±77.26)μg、(9.15±2.77)次,均低于对照组,差异有统计学意义(t=11.945、2.493、12.589,P<0.05)。结论对胸腔镜肺癌手术患者采用超声引导下前锯肌阻滞能维持其术中生命体征稳定,可减轻其术后疼痛感,减少麻醉药物用量。

Objective To investigate the effect of ultrasound-guided anterior serratus block in anesthesia and postop-erative analgesia in thoracoscopic lung cancer surgery.Methods 80 patients with lung cancer undergoing thoraco-scopic surgery admitted to Yangzhou Jiangdu People's Hospital from May 2020 to April 2022 were selected and ran-domly divided into control group(n=40,conventional intravenous and inhalation combined anesthesia)and observation group(n=40,combined with ultrasound-guided anterior serratus muscle block).The average pulse pressure and heart rate,postoperative VAS score,dosage of anesthetic drugs and use of analgesic pump were compared between the two groups.Results The heart rate(82.17±5.72)beats/min and mean arterial pressure(93.12±6.84)mmHg at the time of skin incision in the observation group were lower than those in the control group,and the difference was statistically significant(t=8.473,3.759,P<0.05).The VAS score at rest(0.93±0.34)points,(1.26±0.45)points and the VAS score at activity(1.52±0.60)points and(2.24±0.56)points in the observation group were lower than those in the control group at 4 h and 12 h after operation,and the difference was statistically significant(t=14.669,10.488,13.617,9.613,P<0.05).The dosage of sufentanil and remifentanil and the press times of analgesia pump in the observation group were(38.44±5.02)μg,(1004.13±77.26)μg,(9.15±2.77)times,all lower than those in the control group,the difference was statistically significant(t=11.945,2.493,12.589,P<0.05).Conclusion The use of ultrasound-guided ante-rior serratus muscle block in patients undergoing thoracoscopic surgery for lung cancer can maintain the stability of vi-tal signs during surgery,reduce postoperative pain and reduce the amount of narcotic drugs.