前锯肌阻滞麻醉在肋骨骨折镇痛中的应用

Application of serratus anterior plane block in pain relief for unilateral rib fractures

目的观察超声引导下前锯肌阻滞麻醉(serratus anterior plane block,SAPB)在肋骨骨折患者急性期镇痛中的效果及其对患者早期康复的影响。方法本研究共纳入单侧肋骨骨折保守治疗的患者160例,采用随机数字表法分为A、B两组,每组80例。A组患者单独使用氟比洛芬酯进行止痛治疗,B组患者接受超声引导下SAPB联合氟比洛芬酯进行止痛治疗。通过记录两组患者在治疗前、治疗后1h、6h、12h、24h、48h的数字疼痛量表(numerical rating scale,NRS)评分,额外使用镇痛药物的情况,对不良反应、功能恢复情况(包括肺活量、最大呼气流量和步行距离)及住院时间进行比较分析。结果B组患者治疗后1h、6h、12h的疼痛评分低于A组,差异有统计学意义(P<0.01),而在治疗后24h、48h疼痛评分两组差异无统计学意义(P>0.05)。B组患者额外镇痛药物的使用率、不良反应均少于A组,差异有统计学意义(P<0.01)。B组患者的肺活量、最大呼气流量和步行距离均高于A组,差异有统计学意义(P<0.01)。此外,B组患者的平均住院时间短于A组,差异有统计学意义(P<0.01)。结论超声引导下SAPB联合氟比洛芬酯止痛治疗在肋骨骨折患者中的疗效优于单独使用氟比洛芬酯。SAPB可提供更有效的疼痛控制,且具有较高安全性。

Objective To observe the effects of ultrasound-guided serratus anterior plane block(SAPB)for pain relief in the acute phase of rib fractures and its impact on early rehabilitation.MethodsThis study included 160 patientsfromTaizhou Central Hospitalwith unilateral rib fractures undergoing conservative treatment.The patients were randomly divided into two groups,with 80 patients in each group.Group A received flurbiprofen alone for pain relief,while Group B received ultrasound-guided SAPB combined with flurbiprofen.Numerical rating scale(NRS)before treatment and at 1h,6h,12h,24h,and 48h after treatment,additional analgesic use,adverse reactions,functional recovery parameters(including vital capacity,peak expiratory flow,and walking distance),and hospital stay duration were recorded and compared between the two groups.ResultsThe pain scores in Group B were significantly lower than those in Group A at 1h,6h,and 12h after treatment(P<0.01),with no significant differences at 24h and 48h(P>0.05).The use of additional analgesics and adverse reactions were significantly less in Group B compared to Group A(P<0.01).Group B patients had significantly higher vital capacity,peak expiratory flow,and walking distance(P<0.01).Additionally,the average hospital stay in Group B was significantly shorter than thatin Group A(P<0.01).ConclusionUltrasound-guidedSAPB combined with flurbiprofen is significantly more effective than flurbiprofen alone for treating rib fracture patients.SAPB provides more effective pain control,faster functional recovery,and has a high safety profile.