超声引导下低位前锯肌平面阻滞对上腹部手术患者术后镇痛及炎症反应的影响

目的 评价超声引导下低位前锯肌平面阻滞(SAPB)对上腹部手术患者术后镇痛及炎症反应的影响.方法 择期上腹部手术患者120例,男69例,女51例,年龄18～65岁,ASAⅠ或Ⅱ级.随机分为三组:对照组(C组,n=39),不行神经阻滞;常规SAPB组(SAPB组,n=40),全麻诱导前超声引导下双侧腋中线第5肋水平前锯肌...

Effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia after upper-abdominal surgery

Objective To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia after upper-abdominal surgery.Methods A total of 120 patients scheduled for elective upper-abdominal surgery under general anesthesia,69 males and 51 females,aged 18-65 years,ASA physical statusⅠorⅡ,were divided into 3 groups using a random number table method:control group(group C,n=39),serratus anterior plane block group(group SAPB,n=40),and subserratus anterior plane block group(group SSPB,n=40).In group SSPB,ultrasound-guided subserratus anterior plane block were performed on both sides.Patient-controlled intravenous analgesia(PCIA)was performed at the end of the surgery.PCIA pump was pressed when VAS pain scores≥4 after surgery and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA pressing,and the amount of sufentanil consumed were recorded.Venous blood were collected immediately 4,24,and 48 hours after surgery for determination of serum interleukin-1(IL-1),IL-6,and IL-10 concentrations by enzyme-linked immunosorbent assay.The requirement for rescue analgesia and development of nausea and retching/vomiting were recorded within 48 hours after surgery.Results The amount of sufentanil,the number of remedial analgesia and the number of analgesic pump compressions during the operation and 48 hours after the operation in group SSPB were significantly less than those in group C(P<0.05),and the incidence of adverse reactions in group SSPB was significantly lower than that in group C(P<0.05).The serum levels of IL-1 and IL-6 in group SSPB were significantly lower than those in group C 4,24,and 48 hours after the operation,and the IL-10 concentration in group SSPB was significantly higher than that in group C(P<0.05).There were no statistical differences in the amount of sufentanil,the number of times of analgesic pump compression,salvage analgesia rate,and serum IL-1,IL-6,and IL-10 concentrations at different time points after surgery in groups C and SAPB during operation and 48 hours after operation.Conclusion Ultrasound-guided SSPB provides good efficacy for postoperative analgesia in the patients undergoing upper-abdominal surgeries,and can significantly reduce the release of inflammatory factors.