Department of Anesthesiology, 3th People's Hospital of Chengdu, Southwest Jiaotong University, Chengdu City, Sichuan Province, China.
Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029000.
The aim of this study is to retrospectively analyze and evaluate the effect of transverse thoracic muscle plane (TTP) block as a routine analgesic strategy for cardiac enhanced recovery after surgery in sternotomy.Patients received TTP block after general anesthesia and tracheal intubation were included in this study. The baseline clinical data of the patients, intraoperative use of sufentanil, internal mammary artery separating time, the postoperative duration of invasive ventilation, visual analogue scale, the compression times of patient-controlled intravenous analgesia in the first 3 days after surgery, and postoperative nausea and vomiting were recorded.A total of 104 cases was included and divided to G group (without TTP block) and TTP group (with TTP). Sufentanil use (sufentanil dose/min, sufentanil dose/kg body weight, sufentanil dose/[min kg]) in TTP group was significantly lower than that of G group. In G group, intraoperative use of sufentanil was correlated to the duration of anesthesia (P = .035). The postoperative visual analogue scale pain scores and the compression times of patient-controlled intravenous analgesia in the TTP group were significantly decreased compared with G group (P < .01). The postoperative duration of invasive ventilation of patients with normal and mildly impaired pulmonary function was significantly correlated to the use of sufentanil (P = .027, .009).TTP block has certain analgesic effect and can reduce sufentanil use in medium-length cardiac surgery and postoperative use of opioids. It is indicated that TTP block can be used as a routine enhanced recovery after surgery strategy for sternotomy in cardiac surgery.
本研究旨在回顾性分析和评估经胸横肌平面（TTP）阻滞作为一种常规的胸骨切开术后心脏加速康复的镇痛策略的效果。本研究纳入了全身麻醉和气管插管后接受 TTP 阻滞的患者。记录患者的基线临床数据、术中舒芬太尼的使用、内乳动脉分离时间、术后有创通气时间、视觉模拟评分、术后 3 天内患者自控静脉镇痛的按压次数、以及术后恶心呕吐情况。共纳入 104 例患者，分为 G 组（无 TTP 阻滞）和 TTP 组（有 TTP 阻滞）。TTP 组舒芬太尼的使用（舒芬太尼剂量/分钟、舒芬太尼剂量/公斤体重、舒芬太尼剂量/[分钟公斤]）明显低于 G 组。G 组术中舒芬太尼的使用与麻醉时间相关（P =.035）。与 G 组相比，TTP 组术后视觉模拟评分疼痛评分和患者自控静脉镇痛的按压次数明显减少（P <.01）。肺功能正常和轻度受损患者的术后有创通气时间与舒芬太尼的使用明显相关（P =.027，.009）。TTP 阻滞具有一定的镇痛效果，可以减少中长度心脏手术中的舒芬太尼使用和术后阿片类药物的使用。提示 TTP 阻滞可以作为心脏手术胸骨切开术后加速康复的常规策略。
