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用于电视辅助胸腔镜手术后疼痛管理的前锯肌平面阻滞:一项叙述性综述

Serratus Anterior Plane Block for Pain Management After Video-Assisted Thoracoscopic Surgeries: A Narrative Review.

作者信息

Ahmadzadeh Shahab, Serio Macie A, Nguyen Angela, Dethloff Drew R, Robichaux Camille, Mosieri Chizoba N, Shekoohi Sahar, Kaye Alan D

机构信息

Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.

School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.

出版信息

Medicina (Kaunas). 2025 May 28;61(6):1010. doi: 10.3390/medicina61061010.

Abstract

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive diagnostic and therapeutic procedure utilized in various thoracic conditions. VATS has grown in popularity with ever-expanding knowledge of enhanced recovery after surgery (ERAS) protocols and its benefits regarding patient care and outcomes. Pain control following VATS is of utmost importance to minimize the complication risk. Options for pain control following VATS have traditionally included systemic IV analgesia but have evolved to include loco-regional analgesia as well. The serratus anterior plane block (SAPB) is one form of loco-regional analgesia utilized in VATS that has been shown to provide effective pain control of the anterolateral chest wall. Patients who received SAPB compared to control methods of anesthesia demonstrated significant decreases in postoperative pain and postoperative opioid consumption. SAPB is effective and offers a promising safety profile as the block is typically more superficial than other types of loco-regional analgesia. This review outlines the recent literature surrounding the use of SAPB for pain control in VATS.

摘要

电视辅助胸腔镜手术(VATS)是一种用于多种胸部疾病的微创诊断和治疗方法。随着对术后加速康复(ERAS)方案的了解不断深入及其在患者护理和治疗结果方面的益处,VATS越来越受欢迎。VATS术后的疼痛控制对于将并发症风险降至最低至关重要。传统上,VATS术后的疼痛控制选择包括全身静脉镇痛,但现在也已发展为包括局部区域镇痛。前锯肌平面阻滞(SAPB)是VATS中使用的一种局部区域镇痛形式,已被证明能有效控制胸壁前外侧的疼痛。与对照麻醉方法相比,接受SAPB的患者术后疼痛和术后阿片类药物消耗量显著降低。SAPB是有效的,并且具有良好的安全性,因为该阻滞通常比其他类型的局部区域镇痛更表浅。这篇综述概述了围绕SAPB用于VATS疼痛控制的最新文献。

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