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手术实施的连续浅表前锯肌平面阻滞在单孔电视辅助胸腔镜手术中的安全性和有效性

Safety and efficacy of surgically performed continuous superficial serratus anterior plane block in uniportal video-assisted thoracic surgery.

作者信息

Punzo Giovanni, Nachira Dania, Calabrese Giuseppe, Cambise Chiara, Congedo Maria Teresa, Vita Maria Letizia, Meacci Elisa, Margaritora Stefano

机构信息

Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy.

Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica Del Sacro Cuore, Rome, Italy.

出版信息

J Minim Access Surg. 2025 Apr 1;21(2):162-168. doi: 10.4103/jmas.jmas_345_23. Epub 2024 Jul 30.

Abstract

INTRODUCTION

The 'surgically performed' continuous superficial serratus anterior plane block (continuous s-SAPB) was never described before in uniportal video-assisted thoracic surgery (uniportal VATS) surgery. The aim of the study was to evaluate the safety and efficacy of the technique.

PATIENTS AND METHODS

Between March 2022 and April 2023, 50 patients, undergone uniportal VATS surgery at our thoracic surgery department, were scheduled for a surgically performed continuous s-SAPB as post-operative analgesia protocol.

RESULTS

The mean execution time for the block was 3.92 ± 2.56 min. Ten patients (20%) required morphine for a visual analogue scale (VAS) score >4 immediately after surgery. The recorded VAS score at chest tube removal was 1.87 ± 1.41, whereas 2 h after the manoeuvre was 0.42 ± 0.72. No complication related to block insertion was recorded. The onset of chronic pain was observed in a total of 2 patients (4%).

CONCLUSIONS

The surgically performed continuous s-SAPB in uniportal VATS seems to be safe and easy to perform, and it provides a satisfactory analgesic effect.

摘要

引言

“手术实施的”连续浅表前锯肌平面阻滞(连续s-SAPB)此前从未在单孔电视辅助胸腔镜手术(单孔VATS)中被描述过。本研究的目的是评估该技术的安全性和有效性。

患者与方法

2022年3月至2023年4月期间,在我们胸外科接受单孔VATS手术的50例患者被安排接受手术实施的连续s-SAPB作为术后镇痛方案。

结果

阻滞的平均实施时间为3.92±2.56分钟。10例患者(20%)在术后立即因视觉模拟评分(VAS)>4而需要使用吗啡。拔除胸管时记录的VAS评分为1.87±1.41,而操作后2小时为0.42±0.72。未记录到与阻滞插入相关的并发症。总共观察到2例患者(4%)出现慢性疼痛。

结论

单孔VATS中手术实施的连续s-SAPB似乎安全且易于实施,并提供了令人满意的镇痛效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c97e/12054947/8d3e64bbf51d/JMAS-21-162-g001.jpg

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