Abstract：
Transaxillary endoscopic thyroidectomy (TAET) is favored for its favorable cosmetic outcomes and the preservation of anterior cervical function. Despite these benefits, postoperative analgesia has traditionally relied on pharmacological interventions, and regional anesthetic procedures may be an alternative method. This study aimed to evaluate the efficacy of an ultrasound-guided pectoserratus plane block (PSPB) combined with an intermediate cervical plexus block (ICPB) for TAET.
Forty patients undergoing TAET were randomized into two groups: the nerve block group (N.=20) received ultrasound guided PSPB with 20 ml of 0.375% ropivacaine and ICPB with 8 mL of 0.3% ropivacaine, while the control group (N.=20) received no block. The primary outcome was the Visual Analog Scale (VAS) scores for postoperative neck and axillary pain at different time points (1, 6, 12, 24 h) during rest and movement post-TAET. The secondary outcomes included intraoperative remifentanil consumption, incidence of postoperative nausea and vomiting (PONV), number of remedial analgesic requirements, and patient satisfaction postoperatively.
Compared to the control group, patients in the nerve block had significantly lower VAS scores of the neck and axilla whether at rest or movement, and 1, 6, 12, and 24 h postoperatively (P<0.0125). The nerve block group showed higher patient satisfaction (P<0.001). No difference was observed in intraoperative remifentanil consumption, need for rescue analgesics, or other adverse effects 48 h postoperatively.
Ultrasound-guided PSPB with ICPB significantly alleviated postoperative pain and improved patient satisfaction with TAET.
Forty patients undergoing TAET were randomized into two groups: the nerve block group (N.=20) received ultrasound guided PSPB with 20 ml of 0.375% ropivacaine and ICPB with 8 mL of 0.3% ropivacaine, while the control group (N.=20) received no block. The primary outcome was the Visual Analog Scale (VAS) scores for postoperative neck and axillary pain at different time points (1, 6, 12, 24 h) during rest and movement post-TAET. The secondary outcomes included intraoperative remifentanil consumption, incidence of postoperative nausea and vomiting (PONV), number of remedial analgesic requirements, and patient satisfaction postoperatively.
Compared to the control group, patients in the nerve block had significantly lower VAS scores of the neck and axilla whether at rest or movement, and 1, 6, 12, and 24 h postoperatively (P<0.0125). The nerve block group showed higher patient satisfaction (P<0.001). No difference was observed in intraoperative remifentanil consumption, need for rescue analgesics, or other adverse effects 48 h postoperatively.
Ultrasound-guided PSPB with ICPB significantly alleviated postoperative pain and improved patient satisfaction with TAET.
摘要：
经腋窝内镜甲状腺切除术（TAET）因其良好的美容效果和保留颈椎前路功能而备受青睐。尽管有这些好处,术后镇痛传统上依赖于药物干预，区域麻醉程序可能是一种替代方法。这项研究旨在评估超声引导下的胶质纤维平面阻滞（PSPB）结合中间颈丛阻滞（ICPB）对TAET的疗效。
40例接受TAET的患者被随机分为两组：神经阻滞组(N.=20）接受超声引导的PSPB与20毫升0.375％罗哌卡因和ICPB与8毫升0.3％罗哌卡因，而对照组(N.=20)没有收到阻塞。主要结果是在TAET后休息和运动期间不同时间点（1、6、12、24h）的术后颈部和腋窝疼痛的视觉模拟量表（VAS）评分。次要结果包括术中瑞芬太尼消耗量，术后恶心和呕吐（PONV）的发生率，补救镇痛要求的数量，术后患者满意度。
与对照组相比，神经阻滞患者在休息或运动时，颈部和腋窝的VAS评分均显着降低，术后1、6、12和24h（P<0.0125）。神经阻滞组患者满意度较高(P<0.001)。术中瑞芬太尼消耗量无差异，需要抢救镇痛药，或其他不良反应术后48h。
超声引导下PSPB联合ICPB可显着减轻术后疼痛，提高患者对TAET的满意度。
40例接受TAET的患者被随机分为两组：神经阻滞组(N.=20）接受超声引导的PSPB与20毫升0.375％罗哌卡因和ICPB与8毫升0.3％罗哌卡因，而对照组(N.=20)没有收到阻塞。主要结果是在TAET后休息和运动期间不同时间点（1、6、12、24h）的术后颈部和腋窝疼痛的视觉模拟量表（VAS）评分。次要结果包括术中瑞芬太尼消耗量，术后恶心和呕吐（PONV）的发生率，补救镇痛要求的数量，术后患者满意度。
与对照组相比，神经阻滞患者在休息或运动时，颈部和腋窝的VAS评分均显着降低，术后1、6、12和24h（P<0.0125）。神经阻滞组患者满意度较高(P<0.001)。术中瑞芬太尼消耗量无差异，需要抢救镇痛药，或其他不良反应术后48h。
超声引导下PSPB联合ICPB可显着减轻术后疼痛，提高患者对TAET的满意度。
