Shang Li Hua, Xiao Zhen Nan, Zhao Ya Li, Long Bo
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang 110004, People's Republic of China.
Ther Clin Risk Manag. 2020 Dec 18;16:1257-1265. doi: 10.2147/TCRM.S285244. eCollection 2020.
Fast-track surgery is a developing trend in medical care. It is a core challenge for clinical anesthesia to reasonably reduce the dosage of opioids and relieve postoperative pain. Serratus anterior plane block (SAPB) is a novel analgesic technique with such advantages as easy operation, good safety, and few side effects.
In total, 60 patients aged 18 to 65 years who were diagnosed with lung cancer and scheduled for thoracoscopic resection were randomly assigned to receive SABP or local infiltration anesthesia. We analyzed the time within 48 hrs after operation to visual analogue scale (VAS) pain score of 4 or higher and the number of patients requiring additional analgesics at 6 hrs and 12 hrs after operation.
The estimated median time to VAS ≥4 was 4 hrs (1.32 to 6.68) in the control group and 11 hrs (6.71 to 15.29) in the SAPB group (log-rank test: P=0.008). The number of patients requiring additional analgesics at 6- and 12 hrs after operation was significantly lower in the SAPB group than that in the control group (P<0.05).
Compared with local infiltration, SAPB provided extended postoperative analgesia after thoracoscopic surgery with reduced consumption of additional analgesics in the early postoperative stage.
快速康复外科是医疗护理的发展趋势。合理减少阿片类药物用量并缓解术后疼痛是临床麻醉的核心挑战。前锯肌平面阻滞（SAPB）是一种新型镇痛技术，具有操作简便、安全性好、副作用少等优点。
总共60例年龄在18至65岁之间、被诊断为肺癌且计划接受胸腔镜切除术的患者被随机分配接受前锯肌平面阻滞或局部浸润麻醉。我们分析了术后48小时内视觉模拟评分法（VAS）疼痛评分达到4分或更高的时间，以及术后6小时和12小时需要追加镇痛药的患者数量。
对照组VAS≥4的估计中位时间为4小时（1.32至6.68），前锯肌平面阻滞组为11小时（6.71至15.29）（对数秩检验：P = 0.008）。前锯肌平面阻滞组术后6小时和12小时需要追加镇痛药的患者数量显著低于对照组（P<0.05）。
与局部浸润相比，前锯肌平面阻滞为胸腔镜手术后提供了更长时间的术后镇痛，且术后早期追加镇痛药的消耗量减少。
