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单孔电视辅助胸腔镜手术中经胸腔镜引导胸椎旁阻滞与经胸腔镜引导肋间神经阻滞的术后镇痛效果比较:一项前瞻性随机对照试验。

Comparison of postoperative analgesia by thoracoscopic-guided thoracic paravertebral block and thoracoscopic-guided intercostal nerve block in uniportal video-asssited thoracic surgery: a prospective randomized controlled trial.

机构信息

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.

出版信息

World J Surg Oncol. 2024 Sep 6;22(1):238. doi: 10.1186/s12957-024-03517-z.

Abstract

BACKGROUND

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).

METHODS

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.

RESULTS

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).

CONCLUSION

TG-TPVB demonstrated superior acute pain relieve after uniVATS, shorter surgical time and non-inferior adverse effects than TG-INB.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9877/11380437/fd3369b7c6f6/12957_2024_3517_Fig1_HTML.jpg

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