Department of Anesthesiology, The Affiliated Lihuili Hospital of Ningbo University, No.57 Xingning road, Ningbo, 315040, China.
Department of Thoracic Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China.
World J Surg Oncol. 2024 Sep 6;22(1):238. doi: 10.1186/s12957-024-03517-z.
Thoracoscopic-guided thoracic paravertebral nerve block (TG-TPVB) and thoracoscopic-guided intercostal nerve block (TG-INB) are two postoperative analgesia technology for thoracic surgery. This study aims to compared the analgesic effect of TG-TPVB and TG-INB after uniportal video-asssited thoracic surgery (UniVATS).
Fifty-eight patients were randomly allocated to the TG-TPVB group and the TG-INB group. The surgical time of nerve block, the visual analog scale (VAS) scores, the consumption of sufentanil and the number of patient-controlled intravenous analgesic (PCIA) presses within 24 h after surgery, the incidence of adverse reactions were compared between the two groups.
The VAS scores were significantly lower during rest and coughing at 2, 6, 12, and 24 h in the TG-TPVB group than in the TG-INB group (P < 0.05). The consumption of sufentanil and the number of PCIA presses within 24 h after surgery were significantly lower in the TG-TPVB group than in the TG-INB group (P < 0.001).The surgical time of nerve block was significantly shorter in the TG-TPVB group than in the TG-INB group (P < 0.001). The incidence of bleeding at the puncture point was lower in the TG-TPVB group than that in the TG-INB group (P < 0.05).
TG-TPVB demonstrated superior acute pain relieve after uniVATS, shorter surgical time and non-inferior adverse effects than TG-INB.
胸腔镜引导胸椎旁神经阻滞(TG-TPVB)和胸腔镜引导肋间神经阻滞(TG-INB)是两种用于胸外科手术的术后镇痛技术。本研究旨在比较单孔电视辅助胸腔镜手术(UniVATS)后 TG-TPVB 和 TG-INB 的镇痛效果。
58 例患者随机分为 TG-TPVB 组和 TG-INB 组。比较两组患者神经阻滞的手术时间、术后 24 小时内视觉模拟评分(VAS)评分、舒芬太尼用量和患者自控静脉镇痛(PCIA)按压次数、不良反应发生率。
TG-TPVB 组患者在休息和咳嗽时的 VAS 评分在 2、6、12 和 24 小时均明显低于 TG-INB 组(P<0.05)。TG-TPVB 组患者术后 24 小时内舒芬太尼用量和 PCIA 按压次数明显低于 TG-INB 组(P<0.001)。TG-TPVB 组患者神经阻滞的手术时间明显短于 TG-INB 组(P<0.001)。TG-TPVB 组患者穿刺点出血的发生率明显低于 TG-INB 组(P<0.05)。
与 TG-INB 相比,TG-TPVB 可更有效地缓解 UniVATS 术后急性疼痛,手术时间更短,不良反应发生率无差异。