Huang Yangsi, Ouyang Chengdi, He Fang, Zhong Yu, Liu Guofeng, Lu Yizhi, Chen Yanhua
Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Front Surg. 2025 Feb 20;12:1526890. doi: 10.3389/fsurg.2025.1526890. eCollection 2025.
This study aimed to investigate the effects of ultrasound-guided bilateral parasternal block (PSB) combined with rectus sheath block (RSB) on postoperative recovery quality in patients undergoing median sternotomy for cardiac surgery.
Eighty patients were randomly assigned to either the intervention group (receiving PSB + RSB, = 40) or the control group (not receiving PSB + RSB, = 40). The primary outcome was opioid consumption within the first 24 h postoperatively. Secondary outcomes included Visual Analog Scale (VAS) pain scores and various surgery and recovery-related parameters.
The intervention group showed significantly reduced opioid consumption in the first 24 h postoperatively compared to the control group ( < 0.05), though no significant difference was observed at 48 h postoperatively. VAS pain scores at extubation and at 12, 24, and 48 h post-extubation were significantly lower in the intervention group ( < 0.05). The intervention group also demonstrated superior Quality of Recovery-15 (QoR-15) scores at all observed time points compared to the control group ( < 0.05), with no block-related adverse events. There were no significant differences in surgical and recovery-related parameters between the groups.
Ultrasound-guided bilateral PSB combined with RSB effectively enhances postoperative analgesia and the quality of recovery in patients undergoing median sternotomy for cardiac surgery. The application of ultrasound-guided bilateral parasternal block combined with rectus sheath block in median sternotomy cardiac surgery offers a new pain management strategy that is both safe and highly effective. This approach reduces postoperative analgesic requirements and improves recovery quality for cardiac surgery patients.
https://www.chictr.org.cn/showproj.html?proj=180456, China Clinical Trial Registry (ChiCTR2200064733).
本研究旨在探讨超声引导下双侧胸骨旁阻滞（PSB）联合腹直肌鞘阻滞（RSB）对心脏手术正中开胸患者术后恢复质量的影响。
80例患者被随机分为干预组（接受PSB + RSB，n = 40）或对照组（不接受PSB + RSB，n = 40）。主要结局是术后24小时内的阿片类药物消耗量。次要结局包括视觉模拟评分法（VAS）疼痛评分以及各种手术和恢复相关参数。
与对照组相比，干预组术后24小时内的阿片类药物消耗量显著减少（P < 0.05），但术后48小时未观察到显著差异。干预组拔管时以及拔管后12、24和48小时的VAS疼痛评分显著更低（P < 0.05）。与对照组相比，干预组在所有观察时间点的恢复质量-15（QoR-15）评分也更高（P < 0.05），且无阻滞相关不良事件。两组之间的手术和恢复相关参数无显著差异。
超声引导下双侧PSB联合RSB可有效增强心脏手术正中开胸患者的术后镇痛效果和恢复质量。超声引导下双侧胸骨旁阻滞联合腹直肌鞘阻滞在正中开胸心脏手术中的应用提供了一种安全且高效的新疼痛管理策略。这种方法减少了心脏手术患者的术后镇痛需求并提高了恢复质量。
https://www.chictr.org.cn/showproj.html?proj=180456，中国临床试验注册中心（ChiCTR2200064733）。
