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胸腔镜引导下肋间神经阻滞与超声引导下肋间神经阻滞用于单孔电视辅助肺叶切除术后镇痛的比较:一项前瞻性随机对照试验

Comparison of thoracoscopic-guided intercostal nerve block and ultrasound-guided intercostal nerve block in postoperative analgesia of uniportal video-assisted lobectomy: a pilot randomized controlled trial.

作者信息

Li Yan, Wei Luyao, Du Jian-Hui, He Jin-Xian, Xu Xia, Hu Li-Hong

机构信息

Department of Anesthesiology.

Department of Thoracic Surgery, the affiliated Lihuili Hospital of Ningbo University, Ningbo, China.

出版信息

Int J Surg. 2025 Feb 1;111(2):1995-2001. doi: 10.1097/JS9.0000000000002165.

Abstract

BACKGROUND

Ultrasound-guided intercostal nerve block (UINB) and thoracoscopic-guided intercostal nerve block (TINB) are often used for analgesia after thoracic surgery. Herein, we compared the application of TINB and UINB for analgesia after uniportal video-assisted lobectomy.

METHODS

Sixty patients were randomly allocated into two groups: UINB and TINB. The surgical time of intercostal nerve block (INB), the success rate of the first needle, visual analog scale (VAS) scores, the time of the first patient-controlled intravenous analgesia (PCIA) press, the time for removing the thoracic drainage tube, consumption of sufentanil and the number of PCIA presses within 24 hours postoperatively, and adverse reactions (ARs) were compared between the two groups.

RESULTS

The surgical time of INB was significantly shorter in the TINB group than in the UINB group ( P < 0.001). The time of the first press of PCIA was significantly earlier in the TINB group than in the UINB group ( P < 0.001). The success rate of the first needle was significantly higher in the TINB group than in the UINB group ( P < 0.001). No significant differences were observed between the two groups regarding VAS scores, time for removing the thoracic drainage tube, the consumption of sufentanil, the number of PCIA presses within 24 hours postoperatively, and ARs.

CONCLUSION

TINB and UINB have similar analgesic effects after uniportal video-assisted lobectomy. However, TINB demonstrates shorter surgical time and a higher success rate than UINB.

摘要

背景

超声引导下肋间神经阻滞(UINB)和胸腔镜引导下肋间神经阻滞(TINB)常用于胸科手术后的镇痛。在此,我们比较了TINB和UINB在单孔电视辅助肺叶切除术后镇痛中的应用。

方法

60例患者随机分为两组:UINB组和TINB组。比较两组肋间神经阻滞(INB)的手术时间、首次穿刺成功率、视觉模拟评分(VAS)、首次患者自控静脉镇痛(PCIA)按压时间、胸腔引流管拔除时间、舒芬太尼用量、术后24小时内PCIA按压次数及不良反应(ARs)。

结果

TINB组INB的手术时间显著短于UINB组(P<0.001)。TINB组首次PCIA按压时间显著早于UINB组(P<0.001)。TINB组首次穿刺成功率显著高于UINB组(P<0.001)。两组在VAS评分、胸腔引流管拔除时间、舒芬太尼用量、术后24小时内PCIA按压次数及ARs方面差异无统计学意义。

结论

单孔电视辅助肺叶切除术后,TINB和UINB的镇痛效果相似。然而,TINB的手术时间比UINB短,成功率更高。

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