目的 探讨超声引导前路胸膜外间隙阻滞用于机器人辅助胸腔镜肺手术患者的围术期镇痛效果。 方法 纳入2024年1月至2025年3月择期行机器人辅助胸腔镜肺手术患者64例，随机分为前路胸膜外间隙阻滞联合全麻组（A组，n = 32）和全麻组（G组，n = 32）。记录入手术室时（T₀）、全麻诱导后（T₁）、手术切皮即刻（T₂）、肺组织开始切除即刻（T₃）、手术结束即刻（T₄）及出手术室即刻（T₅）的MAP及HR，记录术中麻药用量，记录术后首次阿片类药物镇痛时间，记录术后12、24及48 h的VAS评分，记录麻醉苏醒、出手术室、术后住院时间及不良反应发生情况。 结果 A组T₂ ~ T₅时MAP及HR低于G组（P < 0.05）。A组术中环泊酚和瑞芬太尼用量少于G组（P < 0.05）。A组术后首次阿片类药物镇痛时间长于G组（P < 0.05）。A组术后12、24及48 h静息和咳嗽时VAS评分低于G组（P < 0.05）。A组麻醉苏醒、出手术室及术后住院时间短于G组（P < 0.05），总体不良反应发生率低于G组（P < 0.05）。 结论 超声引导前路胸膜外间隙阻滞可为机器人辅助胸腔镜肺手术提供良好的围术期镇痛，减少术中麻醉药物用量，降低术后阿片类药物镇痛需求，有利于术后恢复。

Objective To evaluate the perioperative analgesic efficacy of ultrasound-guided anterior extrapleural space block in patients undergoing robot-assisted thoracoscopic lung surgery. Methods A total of 64 patients scheduled for elective robot-assisted thoracoscopic lung surgery between January 2024 and March 2025 were randomly assigned to two groups： the anterior extrapleural space block combined with general anesthesia group （Group A， n = 32） and the general anesthesia-alone group （Group G， n = 32）. The following parameters were recorded： mean arterial pressure （MAP） and heart rate （HR） at baseline （T₀， upon entering the operating room）， after anesthesia induction （T₁）， at skin incision （T₂）， at the start of lung resection （T₃）， at the end of surgery （T₄）， and upon leaving the operating room （T₅）. Intraoperative consumption of anesthetic， time to first postoperative opioid analgesic requirement， Visual Analog Scale （VAS） scores at 12 h， 24 h， and 48 h postoperatively， anesthesia recovery time， operating room exit time， postoperative hospital stay， and adverse events were also documented. Results At the T₂ to T₅ time points， Group A exhibited lower MAP and HR values in comparison with Group G （P < 0.05）. Group A required substantially smaller dosages of ciprofol and remifentanil during the surgical procedure compared with Group G （P < 0.05）. The time to first postoperative opioid analgesia in Group A was longer than that in Group G （P < 0.05）. The VAS scores for rest and coughing in Group A were lower than those in Group G at 12 h， 24 h， and 48 h following surgery （P < 0.05）. Group A exhibited shorter anesthesia recovery time， shorter time to leave the operating room， and reduced postoperative hospital stay compared to Group G（P < 0.05）， with a lower overall incidence of adverse reactions （P < 0.05）. Conclusion Ultrasound-guided anterior extrapleural space block delivers effective perioperative analgesia in robot-assisted thoracoscopic lung surgery， reduces intraoperative anesthetic requirements， decreases postoperative opioid demand， and facilitates recovery.