PDF(Pubmed)
Abstract：
BACKGROUND: The serratus anterior muscle, located in the lateral aspect of the thorax, plays a crucial role in shoulder movement and stability. Thoracoscopic surgery, while minimally invasive, often results in significant postoperative pain, complicating patient recovery and potentially extending hospital stays. Traditional anesthesia methods may not adequately address this pain, leading to increased complications such as agitation due to inadequate pain management.
OBJECTIVE: To evaluate the application value of ultrasound-guided serratus anterior plane block (SAPB) in patients undergoing thoracoscopic surgery, focusing on its effects on postoperative analgesia and rehabilitation.
METHODS: Eighty patients undergoing thoracoscopic surgery between August 2021 and December 2022 were randomly divided into two groups: An observation group receiving ultrasound-guided SAPB and a control group receiving standard care without SAPB. Both groups underwent general anesthesia and were monitored for blood pressure, heart rate (HR), oxygen saturation, and pulse. The primary outcomes measured included mean arterial pressure (MAP), HR, postoperative visual analogue scale (VAS) scores for pain, supplemental analgesic use, and incidence of agitation.
RESULTS: The observation group showed significantly lower cortisol and glucose concentrations at various time points post-operation compared to the control group, indicating reduced stress responses. Moreover, MAP and HR levels were lower in the observation group during and after surgery. VAS scores were significantly lower in the observation group at 1 h, 4 h, 6 h, and 12 h post-surgery, and the rates of analgesic supplementation and agitation were significantly reduced compared to the control group.
CONCLUSIONS: Ultrasound-guided SAPB significantly improves postoperative analgesia and reduces agitation in patients undergoing thoracoscopic surgery. This technique stabilizes perioperative vital signs, decreases the need for supplemental analgesics, and minimizes postoperative pain and stress responses, underscoring its high application value in enhancing patient recovery and rehabilitation post-thoracoscopy.
OBJECTIVE: To evaluate the application value of ultrasound-guided serratus anterior plane block (SAPB) in patients undergoing thoracoscopic surgery, focusing on its effects on postoperative analgesia and rehabilitation.
METHODS: Eighty patients undergoing thoracoscopic surgery between August 2021 and December 2022 were randomly divided into two groups: An observation group receiving ultrasound-guided SAPB and a control group receiving standard care without SAPB. Both groups underwent general anesthesia and were monitored for blood pressure, heart rate (HR), oxygen saturation, and pulse. The primary outcomes measured included mean arterial pressure (MAP), HR, postoperative visual analogue scale (VAS) scores for pain, supplemental analgesic use, and incidence of agitation.
RESULTS: The observation group showed significantly lower cortisol and glucose concentrations at various time points post-operation compared to the control group, indicating reduced stress responses. Moreover, MAP and HR levels were lower in the observation group during and after surgery. VAS scores were significantly lower in the observation group at 1 h, 4 h, 6 h, and 12 h post-surgery, and the rates of analgesic supplementation and agitation were significantly reduced compared to the control group.
CONCLUSIONS: Ultrasound-guided SAPB significantly improves postoperative analgesia and reduces agitation in patients undergoing thoracoscopic surgery. This technique stabilizes perioperative vital signs, decreases the need for supplemental analgesics, and minimizes postoperative pain and stress responses, underscoring its high application value in enhancing patient recovery and rehabilitation post-thoracoscopy.
摘要：
背景：前锯齿肌，位于胸部的侧面，在肩部的运动和稳定性中起着至关重要的作用。胸腔镜手术,虽然微创，通常会导致严重的术后疼痛，使患者康复复杂化，并可能延长住院时间。传统的麻醉方法可能无法充分解决这种疼痛，导致增加的并发症，如由于疼痛管理不足而引起的躁动。
目的：评价超声引导下前锯肌平面阻滞(SAPB)在胸腔镜手术中的应用价值。重点研究其对术后镇痛和康复的影响。
方法：将2021年8月至2022年12月行胸腔镜手术的80例患者随机分为两组：观察组接受超声引导下SAPB治疗，对照组接受标准护理，无SAPB治疗。两组均行全身麻醉,监测血压,心率(HR),氧饱和度,和脉搏。测量的主要结果包括平均动脉压(MAP)，HR,术后疼痛视觉模拟评分（VAS）评分，补充镇痛剂使用，和躁动的发生率。
结果：与对照组相比，观察组在术后各个时间点的皮质醇和葡萄糖浓度显着降低，表明减少的应激反应。此外，观察组患者术中、术后MAP和HR水平均较低。1h时观察组VAS评分明显低于对照组,4h,6h,术后12小时，与对照组相比，镇痛补充和躁动的发生率显着降低。
结论：超声引导下的SAPB可显著改善胸腔镜手术患者的术后镇痛和躁动。这项技术稳定了围手术期的生命体征，减少了对补充镇痛药的需求，减少术后疼痛和应激反应，强调其在促进患者康复和胸腔镜术后康复中的应用价值。
目的：评价超声引导下前锯肌平面阻滞(SAPB)在胸腔镜手术中的应用价值。重点研究其对术后镇痛和康复的影响。
方法：将2021年8月至2022年12月行胸腔镜手术的80例患者随机分为两组：观察组接受超声引导下SAPB治疗，对照组接受标准护理，无SAPB治疗。两组均行全身麻醉,监测血压,心率(HR),氧饱和度,和脉搏。测量的主要结果包括平均动脉压(MAP)，HR,术后疼痛视觉模拟评分（VAS）评分，补充镇痛剂使用，和躁动的发生率。
结果：与对照组相比，观察组在术后各个时间点的皮质醇和葡萄糖浓度显着降低，表明减少的应激反应。此外，观察组患者术中、术后MAP和HR水平均较低。1h时观察组VAS评分明显低于对照组,4h,6h,术后12小时，与对照组相比，镇痛补充和躁动的发生率显着降低。
结论：超声引导下的SAPB可显著改善胸腔镜手术患者的术后镇痛和躁动。这项技术稳定了围手术期的生命体征，减少了对补充镇痛药的需求，减少术后疼痛和应激反应，强调其在促进患者康复和胸腔镜术后康复中的应用价值。
