单孔电视辅助胸腔镜手术患者不同麻醉与镇痛方法的临床分析。

Clinical Analysis of Different Anesthesia and Analgesia Methods for Patients Undergoing Uniportal Video-assisted Lung Surgery.

机构信息

Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Clin Ther. 2024 Jul;46(7):570-575. doi: 10.1016/j.clinthera.2024.06.009. Epub 2024 Jul 21.

DOI:10.1016/j.clinthera.2024.06.009

PMID:39039005

Abstract

PURPOSE

The purpose of this study was to compare 3 intraoperative modalities to determine the best and most convenient one for pain control for uniportal lung surgery. This study compared general anesthesia with serratus plane block, general anesthesia with epidural, and general anesthesia alone to examine postoperative pain scores in patients.

METHODS

Eighty patients were enrolled and statistically analyzed. Three interventions were studied: general anesthesia with serratus plane block (group S), general anesthesia with thoracic epidural (group E), and general anesthesia only (group G). Outcome measures compared among the 3 groups included demographic characteristics; surgical types; anesthesia and operative time; postoperative pain scores; vital signs; morphine consumption at 0, 2, and 6 hours and day 1 and day 2 after surgery; incidence of opioid-related adverse events and chronic pain; hospital length of stay (LOS); and overall expenses. The numerical rating scale was used to assess the degree of pain on the first and second postoperative days. Postoperative morphine consumption, incidence of opioid-related side effects, hospital LOS, and overall hospital expenses were documented, as well as incidence of chronic postoperative pain.

FINDINGS

There was no difference in the incidence of opioid-related adverse events and chronic pain, hospital LOS, and overall expenses among the 3 groups. After investigating factors that may influence hospital LOS and overall expenses, the multivariable analysis indicated that only longer operative time was associated with longer hospital stay and more hospital expenses.

IMPLICATIONS

This prospective study found that general anesthesia alone offers an easy and efficient approach resulting in similar postoperative pain scores and morphine consumption compared with nerve block and epidural. Longer operative time was associated with longer hospital stay and more hospital expenses.

CLINICALTRIALS

摘要

目的

本研究旨在比较三种术中模式，以确定用于单孔肺手术的最佳和最方便的控制疼痛方法。本研究比较了全身麻醉联合胸肌皮神经阻滞（S 组）、全身麻醉联合硬膜外阻滞（E 组）和单纯全身麻醉（G 组），以检查患者的术后疼痛评分。

方法

共纳入 80 例患者进行统计学分析。研究了三种干预措施：全身麻醉联合胸肌皮神经阻滞（S 组）、全身麻醉联合硬膜外阻滞（E 组）和单纯全身麻醉（G 组）。比较三组间的结局指标包括人口统计学特征、手术类型、麻醉和手术时间、术后疼痛评分、生命体征、术后 0、2、6 小时及术后第 1、2 天吗啡消耗量、阿片类药物相关不良反应和慢性疼痛的发生率、住院时间（LOS）和总费用。使用数字评分量表评估术后第 1 天和第 2 天的疼痛程度。记录术后吗啡消耗量、阿片类药物相关不良反应发生率、住院 LOS 和总住院费用以及慢性术后疼痛的发生率。