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前锯肌平面阻滞作为胸腔镜活检手术成功的单一麻醉技术:病例系列

Serratus anterior plane block as a successful single anesthesia technique for thoracoscopy biopsy surgery: A case series.

作者信息

Hartono Ruddi, Willianto Andreas, Basuki Djudjuk Rahmad, Asmoro Aswoco Andyk, Fadhlurrahman Ahmad Feza

机构信息

Department of Anesthesiology and Intensive Therapy, Medicine Faculty, Brawijaya University/Dr. Saiful Anwar General Hospital, Malang, Indonesia.

出版信息

Saudi J Anaesth. 2023 Jul-Sep;17(3):430-433. doi: 10.4103/sja.sja_907_22. Epub 2023 Jun 22.

Abstract

Thoracic surgery is one of the most common surgeries that causes severe postoperative pain. Inadequate pain management results in longer hospital stays and recovery periods, as well as psychological changes, quality of life, and patient satisfaction. Ultrasound-guided serratus anterior plane block (SAPB) is a promising interfascial plane block that may provide adequate analgesia. We report three cases of suspected lung cancer patients who underwent thoracoscopic biopsy and postoperative chest drainage. The patients underwent SAPB with light sedation during the procedure. After surgery, the patients were observed in the intensive care unit. For postoperative pain management, nonsteroidal anti-inflammatory drugs (NSAIDs) were used as an adjunct to intraoperative SAPB. Adequate pain control was achieved on a numeric rating scale of 0 to 2 over the 1 × 24 postoperative period, and opioid analgesics were not used in these patients. SAPB was successfully used in patients undergoing thoracoscopy biopsy surgery, with excellent outcomes in pain control after the surgery, reduction in perioperative opioid administration, and decreased postoperative pulmonary complications.

摘要

胸外科手术是导致严重术后疼痛的最常见手术之一。疼痛管理不当会导致住院时间和恢复周期延长,以及心理变化、生活质量和患者满意度下降。超声引导下前锯肌平面阻滞(SAPB)是一种有前景的筋膜间平面阻滞方法,可能提供充分的镇痛效果。我们报告了3例疑似肺癌患者,他们接受了胸腔镜活检和术后胸腔引流。手术过程中患者在轻度镇静下接受了SAPB。术后,患者在重症监护病房接受观察。对于术后疼痛管理,非甾体类抗炎药(NSAIDs)作为术中SAPB的辅助用药。在术后1×24小时期间,数字评分量表上的疼痛控制良好,评分为0至2,这些患者未使用阿片类镇痛药。SAPB成功应用于接受胸腔镜活检手术的患者,术后疼痛控制效果极佳,围手术期阿片类药物使用减少,术后肺部并发症也有所减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a213/10435793/89bc6b85a781/SJA-17-430-g001.jpg

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