关键词:

老年胸腔镜, 连续前锯肌平面阻滞, 连续胸椎旁阻滞, 镇痛效果

Abstract:

Objective To compare the analgesic effects between continuous serratus plane block and parathoracic block after thoracoscopic surgery in elderly patients. Methods Elderly patients undergoing thoraco⁃ scopic surgery in our hospital were selected and randomly divided into group S and group T. The patients in group S received continuous serratus plane block under ultrasound guidance before anesthesia induction，while group T continuous thoracic paraspinal block. Time of block operation and success rate of one puncture were recorded. VAS scores of at rest and cough pain 2，6，12，24 and 48 h after the operation were recorded. Pressing times of analgesia pump，the number of cases of sufentanil remedial analgesia and the score of satisfaction were recorded. PSQI scores 24 h before，24 h and 48 h after operation，the incidence of adverse reactions within 48 hours after the operation were recorded. Results Block operation time was significantly reduced（P＜0.05）；but success rate of one puncture and satisfaction rate was significantly increased（P＜0.05）and the incidence of hypotension was signif⁃ icantly reduced（P＜0.05）in group S when compared with those in group T. There was no significant difference in terms of VAS score of at rest and cough pain，times of pressing analgesia pump and the number of sufentanil reme⁃ dial analgesia cases between the two groups（P＞0.05）. Conclusion Both of the two methods can reduce the pain after thoracoscopic surgery in the elderly，and the analgesic effect of the two methods is similar. In contrast，contin⁃ uous serratus plane block has shorter operation time，higher success rate of puncture，lower incidence of hypoten⁃ sion during analgesia，improved sleep quality and higher satisfaction.

Key words:

thoracoscopic surgery for the elderly, continuous serratus plane block, continuous thoracic paravertebral block, analgesic effect