Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Department of Nursing, The first Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
J Card Surg. 2021 Aug;36(8):2818-2823. doi: 10.1111/jocs.15666. Epub 2021 May 28.
The mid-sternum is the main source of pain after open cardiac surgery. The aim of this study was to investigate the effect of bilateral transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery.
Sixty patients were randomly divided into two groups: bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary endpoint was perioperative sufentanil consumption. The secondary outcome measures included postoperative pain, flurbiprofen axetil administration, quality of sleep after extubation, time to extubation, time to the return of gastrointestinal function, time to drain removal, the Intensive Care Unit (ICU) stay time, and hospital stay.
The TP group reported significantly less sufentanil and flurbiprofen axetil consumption than the CO group. The CO group had higher Numerical Rating Scale (NRS) pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and during movement than the TP groups. Compared with the CO group，time to extubation, time to the first bowel movement, ICU stay time, and hospital stay were significantly decreased in the TP group. The TP group was rated as better in the quality of the two nights of sleep after extubation.
Bilateral TTMP blocks can provide good perioperative analgesia for patients undergoing open cardiac surgery and promote postoperative recovery.
胸骨中下段是体外循环心脏直视手术后疼痛的主要来源。本研究旨在探讨双侧腹横肌平面阻滞（TTMP）对体外循环心脏直视手术的影响。
将 60 例患者随机分为两组：双侧 TTMP 阻滞（TP 组）或无神经阻滞（CO 组）。主要终点是围手术期舒芬太尼的消耗量。次要观察指标包括术后疼痛、氟比洛芬酯的使用、拔管后睡眠质量、拔管时间、胃肠功能恢复时间、引流管拔除时间、重症监护病房（ICU）入住时间和住院时间。
TP 组舒芬太尼和氟比洛芬酯的消耗量明显低于 CO 组。CO 组在拔管后 1、2、6、12 和 24 小时，无论是在休息时还是在运动时，NRS 疼痛评分均明显高于 TP 组。与 CO 组相比，TP 组拔管时间、首次排便时间、ICU 入住时间和住院时间明显缩短。TP 组在拔管后两晚的睡眠质量评分更高。
双侧 TTMP 阻滞可为体外循环心脏直视手术患者提供良好的围手术期镇痛，并促进术后恢复。
