不同浓度罗哌卡因前锯肌平面阻滞于机器人辅助胸腔镜下肺切除术患者的镇痛效果

Analgesic Effect of Different Concentrations of Ropivacaine in Patients Undergoing Robot-Assisted Pulmonary Resections Abstract

摘要: 目的：分析不同浓度盐酸罗哌卡因前锯肌平面阻滞(SAPB)在机器人辅助胸腔镜下肺切除术手术患者中的镇痛效果。方法：选取2021年12月至2022年10月青岛大学附属医院收治的100例肺癌患者为研究对象，按随机数字表法将患者分为A组、S1组、S2组、S3组，各25例。4组均行达芬奇机器人辅助胸腔镜下肺切除术治疗，A组行单纯全身麻醉，另外3组术中分别采用0.25%、0.375%、0.50%浓度盐酸罗哌卡因进行SAPB麻醉，比较4组患者术后疼痛程度、静脉自控镇痛(PCIA)使用状况及并发症发生状况。结果：与A组相比，S3组T2-3时静态VAS评分及T1-5时动态VAS评分降低(P < 0.05)，S2组T2时静态VAS评分及动态评分降低(P < 0.05)。与S1组相比，S3组T2、T3、T5时静态VAS评分及T1、T2、T3、T5时动态VAS评分降低(P < 0.05)。与S2组相比，S3组T2、T3、T5时静态VAS评分及动态VAS评分降低(P < 0.05)。其余各时间点组间动静态VAS评分比较差异无统计学意义(P > 0.05)。S3组的镇痛泵药液用量低于A组、S1组、S2组(P < 0.05)，补救镇痛次数低于A组、S1组(P < 0.05)。四组术后头晕头痛、恶心呕吐等不良反应发生率无明显差异。结论：0.5%的罗哌卡因用于前锯肌平面阻滞更有利于缓解机器人辅助胸外科(RATS)肺切除术后疼痛，延长镇痛持续时间，减少镇痛药物用量，适用于RATS肺切除手术后疼痛管理。

Abstract: Objective: To analyze the analgesic effect of different concentrations of ropivacaine hydrochloride anterior serratus plane block (SAPB) in patients undergoing robot-assisted pulmonary resections abstract. Methods: A total of 100 patients with lung cancer admitted to the Affiliated Hospital of Qingdao University from December 2021 to October 2022 were selected as the study subjects. Ac-cording to the random number table method, the patients were divided into group A, group S1, group S2 and group S3, with 25 cases in each group. All 4 groups received robot-assisted thoraco-scopic pneumonectomy. Group A underwent simple general anesthesia. SAPB anesthesia was per-formed with 0.25%, 0.375% and 0.50% ropivacaine in the other three groups. Compared with group A, the static VAS score at T2-3 and the dynamic VAS score at T1-5 were decreased in group S3 (P < 0.05). The static VAS score and dynamic VAS score at T2 in group S2 decreased (P < 0.05). Compared with group S1, the static VAS scores at T2, T3 and T5 and the dynamic VAS scores at T1, T2, T3 and T5 in group S3 were decreased (P < 0.05). Compared with group S2, the static VAS score and dynamic VAS score at T2, T3 and T5 in group S3 were decreased (P < 0.05). There was no signif-icant difference in dynamic and static VAS scores between groups at other time points (P > 0.05). The dosage of analgesic pump in group S3 was lower than that in group A, group S1 and group S2 (P < 0.05), and the number of remedial analgesia was lower than that in group A and group S1 (P < 0.05). There was no significant difference in the incidence of adverse reactions, such as dizziness, headache, nausea and vomiting among the four groups. Results: 0.5% ropivacaine for serratus an-terior plane block is more conducive to relieving pain after robot-assisted thoracic surgery (RATS) pneumonectomy, prolonging the duration of analgesia, reducing the amount of analgesic drugs, and is suitable for pain management after RATS pneumonectomy.