Ökmen Korgün, Ökmen Burcu Metin
Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Emniyet Street, 16130, Bursa, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
J Anesth. 2017 Aug;31(4):579-585. doi: 10.1007/s00540-017-2364-9. Epub 2017 Apr 26.
A multimodal analgesic approach is necessary for post-thoracotomy pain, which can be severe. Intravenous access, central and peripheral nerve blocks are frequently used. The aim of this study was to evaluate the efficacy of serratus anterior plane block (SAPB) in the management of post-thoracotomy pain.
A total of 40 patients who underwent thoracotomy between January 2014 and January 2016 were retrospectively analyzed. The patients were divided into two groups: Group M (intravenous patient-controlled analgesia morphine; n = 20) and Group S (intravenous patient-controlled analgesia morphine + SAPB; n = 20). The Visual Analogue Scale (VAS) was used for pain evaluation at the 1st, 2nd, 4th, 6th, 8th, 12th and 24th postoperative hours and morphine consumption was evaluated at the 6th, 12th and 24th postoperative hours. Secondary outcomes were additional analgesic requirement, side effects, the Ramsay Sedation Scale (RSS) scores, block onset time and block level.
The VAS scores and the amount of morphine consumed at the 6th, 12th and 24th hours were found to be significantly lower in Group S than in Group M (P < 0.001). No statistically significant difference was found in the rate of side effects, including nausea, vomiting, pruritus, respiratory depression, bradycardia and hypotension, and RSS outcomes between the groups.
Our study suggests that SAPB is an effective adjuvant treatment option for thoracotomy analgesia.
开胸术后疼痛可能较为严重,因此需要采用多模式镇痛方法。静脉通路、中枢和外周神经阻滞经常被使用。本研究的目的是评估前锯肌平面阻滞(SAPB)在开胸术后疼痛管理中的疗效。
回顾性分析2014年1月至2016年1月期间接受开胸手术的40例患者。患者分为两组:M组(静脉自控镇痛吗啡;n = 20)和S组(静脉自控镇痛吗啡 + SAPB;n = 20)。在术后第1、2、4、6、8、12和24小时使用视觉模拟评分法(VAS)评估疼痛,并在术后第6、12和24小时评估吗啡消耗量。次要结果包括额外的镇痛需求、副作用、 Ramsay镇静评分(RSS)、阻滞起效时间和阻滞平面。
发现S组在术后第6、12和24小时的VAS评分和吗啡消耗量显著低于M组(P < 0.001)。两组之间在包括恶心、呕吐、瘙痒、呼吸抑制、心动过缓和低血压等副作用发生率以及RSS结果方面未发现统计学上的显著差异。
我们的研究表明,SAPB是开胸术后镇痛的一种有效辅助治疗选择。