Ökmen Korgün, Köprücüoğlu Mustafa
Department of Anaesthesiology and Reanimation, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Department of Thoracic Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Turk J Anaesthesiol Reanim. 2021 Jun;49(3):211-217. doi: 10.5152/TJAR.2020.471.
Video-assisted thoracoscopic surgery (VATS) techniques are commonly used for surgical procedures within the thoracic cavity with smaller incisions. There are very few regional anesthesia methods used to achieve this goal. This study aimed to investigate the effect of two fascial plane block technique rhomboid intercostal block (RIB) and serratus anterior plane block (SAPB) administered on pain scores after VATS.
A total of 90 patients who underwent VATS were included in this study. Patients were divided in three groups: Group R (intravenous patient-controlled analgesia (IV. PCA) +RİB with (25 mL 0.25% bupivacaine; n=30), Group S (IV. PCA + SAPB with (25 mL 0.25% bupivacaine; n=30), and Group C (IV. PCA). The primary outcome was determined as a tramadol consumption amount (at hours 6, 12, and 24). Postoperative pain was evaluated using the VAS (at the 30th minute, 2nd, 6th, 12th, and 24th hours) scores. Secondary outcomes included the side effect profile and additional analgesic use.
VAS scores of the Group R were found to be statistically significantly lower to those of Group S and Group C (p<0.05). A comparison of Groups R and S with Group C in terms of tramadol consumption amounts, at all measurement time points, revealed statistically significantly lower values (p<0.005).
As per the results of this study, we believe that RİB and SAPB administration for pain palliation after VATS is an effective analgesia technique.
电视辅助胸腔镜手术（VATS）技术常用于胸腔内手术，切口较小。用于实现这一目标的区域麻醉方法很少。本研究旨在探讨两种筋膜平面阻滞技术——菱形肌肋间阻滞（RIB）和前锯肌平面阻滞（SAPB）对VATS术后疼痛评分的影响。
本研究共纳入90例行VATS的患者。患者分为三组：R组（静脉自控镇痛（IV.PCA）+25 mL 0.25%布比卡因的RIB；n=30），S组（IV.PCA+25 mL 0.25%布比卡因的SAPB；n=30），C组（IV.PCA）。主要结局指标为曲马多消耗量（6、12和24小时）。使用视觉模拟评分法（VAS）（在第30分钟、第2、6、12和24小时）评估术后疼痛。次要结局指标包括副作用情况和额外镇痛药物的使用。
发现R组的VAS评分在统计学上显著低于S组和C组（p<0.05）。在所有测量时间点，R组和S组与C组在曲马多消耗量方面的比较显示，R组和S组的值在统计学上显著更低（p<0.005）。
根据本研究结果，我们认为VATS术后给予RIB和SAPB进行疼痛缓解是一种有效的镇痛技术。
