Department of Anesthesiology and Pain Medicine, Affiliated Hospital of Jiaxing University, Jiaxing, China.
Department of Critical Medicine, First Affiliated Hospital of Nanchang University, Nanchang City, China.
Ann Thorac Surg. 2022 Jul;114(1):319-326. doi: 10.1016/j.athoracsur.2021.06.068. Epub 2021 Jul 30.
Rhomboid intercostal block is a type of plane block used for postoperative analgesia after video-assisted thoracoscopic surgery. This prospective randomized controlled trial was conducted to investigate the effects of ultrasound-guided continuous rhomboid intercostal block (CRIB) on the global Quality of Recovery (QoR-40) scores and postoperative analgesia after video-assisted thoracoscopic surgery.
A total of 66 adult patients scheduled for elective unilateral video-assisted thoracoscopic surgery were randomly allocated to group C and group CRIB. In group C, patients were administered patient-controlled intravenous analgesia with sufentanil after operation. Patients in group CRIB received patient-controlled analgesia with ropivacaine CRIB. All patients completed the QoR-40 test during the preoperative evaluation and again 24 hours after the operation. Information on 48-hour postoperative pain and adverse events was recorded.
The QoR-40 scores of group C were significantly lower than the scores of group CRIB (155.4 ± 6.1 vs 172.6 ± 6.3; P < .001), with a mean difference of -17.2 (95% CI, -20.4 to -13.9) 24 hours after operation. The postoperative numeric rating scale scores in group CRIB at 6, 12, 18, and 24 hours after the surgical procedure, when patients were at rest, were significantly lower than the scores in group C (all P < .05). The postoperative numeric rating scale scores in group CRIB at 1, 3, 6, 12, 18, 24, and 36 hours after surgical procedure, when patients were moving, were significantly lower than the scores in group C (all P < .05).
In patients who underwent video-assisted thoracoscopic surgery, CRIB led to improved quality of recovery and postoperative analgesia.
肋横突间阻滞是一种用于电视辅助胸腔镜手术后的平面阻滞方法。本前瞻性随机对照试验旨在研究超声引导下连续肋横突间阻滞（CRIB）对电视辅助胸腔镜手术后的整体恢复质量（QoR-40）评分和术后镇痛的影响。
共 66 例择期行单侧电视辅助胸腔镜手术的成年患者随机分为 C 组和 CRIB 组。C 组患者术后接受舒芬太尼患者自控静脉镇痛。CRIB 组患者接受罗哌卡因 CRIB 患者自控镇痛。所有患者在术前评估和术后 24 小时均完成 QoR-40 测试。记录 48 小时内术后疼痛和不良反应的信息。
C 组 QoR-40 评分明显低于 CRIB 组（155.4±6.1 比 172.6±6.3；P<0.001），术后 24 小时差值为-17.2（95%CI，-20.4 至-13.9）。CRIB 组术后 6、12、18 和 24 小时静息时的数字评分量表评分明显低于 C 组（均 P<0.05）。CRIB 组术后 1、3、6、12、18、24 和 36 小时活动时的数字评分量表评分明显低于 C 组（均 P<0.05）。
在接受电视辅助胸腔镜手术的患者中，CRIB 可改善恢复质量和术后镇痛效果。
