不同镇痛方法用于电视胸腔镜肺癌手术的效果比较

Comparison of different analgesic methods in video-assisted thoracoscopic surgery for lung cancer

目的探讨不同镇痛方法用于电视胸腔镜肺癌手术患者术后镇痛的效果及对术后恢复的影响。方法选取2018年8月至2021年12月舟山医院收治的肺癌并行电视胸腔镜手术治疗患者共120例,按随机数字表法分为前锯肌阻滞镇痛组、肋间神经阻滞镇痛组、静脉泵镇痛组和传统镇痛组,每组各30例。分别于术后6、12、24、48 h行疼痛视觉模拟量表(VAS)评估疼痛情况,同时观察是否有不良反应,对比4组患者术后镇痛针剂应用剂量、术后拔除胸管时间及术后住院时间。结果4组患者术后12、24、48 h VAS评分比较差异均有统计学意义(均P<0.05);静脉镇痛泵组术后12 h VAS评分相对较高,与前锯肌阻滞组、肋间神经阻滞组及传统镇痛组比较差异均有统计学意义(均P<0.05);前锯肌阻滞组术后24、48 h VAS评分相对较低,与肋间神经阻滞组、静脉镇痛泵组及传统镇痛组比较差异均有统计学意义(均P<0.05)。静脉镇痛泵组术后拔管时间最长,而前锯肌阻滞组术后住院时间最短。结论前锯肌阻滞镇痛方式用于胸腔镜肺癌手术能获得更好的镇痛效果,有利于患者的快速康复,值得临床推广。

Objective To compare the efficacy of different analgesic methods in patients undergoing video-assisted thoracoscopic surgery for lung cancer.Methods A total of 120 patients with lung cancer undergoing video-assisted thoracoscopic surgery in Zhoushan Hospital from August 2018 to December 2021 were randomly divided into 4 groups:anterior serration muscle block analgesia group,intercostal nerve block analgesia group,intravenous pump analgesia group,and conventional analgesia group,with 30 patients in each group.Pain visual analogue scale(VAS)scores were assessed at 6,12,24 and 48 h after surgery,adverse reactions were observed.The dose of postoperative analgesics,the time of thoracic tube removal,and the postoperative hospital stay were compared among groups.Results The differences in VAS scores between the four groups of patients at 12,24,and 48 h after surgery were statistically significant(all P<0.05);and the intravenous analgesia pump group had a higher VAS score at 12 h after surgery;while the serratus anterior block group had lower pain scores at 24 and 48 h after surgery.The postoperative extubation time was the longest in the intravenous analgesic pump group,while the postoperative hospitalization time was the shortest in the serratus anterior block group.Conclusion Serratus anterior block analgesia can achieve a better analgesic effect after thoracoscopic lung cancer surgery,which is conducive to the rapid recovery of patients,and is worthy of clinical promotion.