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首页> 外文期刊>Saudi Journal of Anaesthesia >Ultrasound-guided serratus anterior plane block versus thoracic paravertebral block for perioperative analgesia in thoracotomy
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Ultrasound-guided serratus anterior plane block versus thoracic paravertebral block for perioperative analgesia in thoracotomy

机译：超声引导下锯齿肌前平面阻滞与胸椎旁阻滞在开胸手术中的围手术期镇痛中的应用

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Background: Thoracotomy needs adequate powerful postoperative analgesia. This study aims to compare the safety and efficacy of ultrasound (US)-guided serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) for perioperative analgesia in cancer patients having lung lobectomy. Patients and Methods: This clinical trial involved 90 patients with lung cancer scheduled for lung lobectomy randomly divided into three groups according to the type of preemptive regional block. Group TPVB received US-guided TPVB. In Group SAPB, US-guided SAPB was performed. The patients of the control Group received general anesthesia alone. The outcome measures were postoperative visual analog scale (VAS) score, intraoperative fentanyl consumption, time of first rescue analgesic, total dose postoperative analgesic, and drug-related adverse effects. Results: Analgesia was adequate in TPVB and SAPB groups up to 24 h. VAS score was comparable in TPVB and SAPB groups and significantly lower compared to control group up to 9 h postoperatively. At 12 and 24 h, TPVB group had significantly lower VAS score relative to SAPB and control groups. Total intraoperative fentanyl consumption was significantly lower in TPVB and SAPB Groups compared to control group. The majority of TPVB Group cases did not need rescue morphine, while the majority of control group needed two doses ( P 0.001). The hemodynamic variables were stable in all patients. Few cases reported trivial adverse effects. Conclusion: Preemptive TPVB and SAPB provide comparable levels of adequate analgesia for the first 24 h after thoracotomy. TPVB provided better analgesia after 12 h. The two procedures reduce intraoperative fentanyl and postoperative morphine consumption.
机译：背景：开胸手术需要足够强力的术后镇痛。这项研究的目的是比较超声（US）引导的锯齿肌前平面阻滞（SAPB）和胸椎旁阻滞（TPVB）对患有肺叶切除术的癌症患者围手术期镇痛的安全性和有效性。患者和方法：该临床试验涉及90例计划行肺叶切除术的肺癌患者，根据先发性区域性阻塞类型将其随机分为三组。 TPVB组收到了美国指导的TPVB。在SAPB组中，执行了美国指导的SAPB。对照组患者仅接受全身麻醉。结局指标为术后视觉模拟量表（VAS）评分，术中芬太尼消耗量，首次急救镇痛时间，术后总镇痛剂量以及药物相关的不良反应。结果：TPVB和SAPB组中止痛至24小时均足够。 TPVB和SAPB组的VAS评分相当，并且在术后9小时之内与对照组相比明显降低。与SAPB组和对照组相比，TPVB组在12和24 h时VAS评分明显降低。与对照组相比，TPVB和SAPB组的术中总芬太尼消耗量显着降低。 TPVB组的大多数病例不需要急救吗啡，而对照组的大多数则需要两次剂量（P <0.001）。所有患者的血流动力学变量均稳定。很少有病例报告过轻微的不良反应。结论：先发制人的TPVB和SAPB在开胸后的最初24小时内可提供相当水平的足够的镇痛作用。 TPVB在12小时后提供了更好的镇痛作用。两种方法可减少术中芬太尼和术后吗啡的消耗。

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