Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery

Xiansong LU; Dongyan GUO; Fei QIAO

doi:10.12259/j.issn.2095-610X.S20221226

Volume 43 Issue 12

Dec. 2022

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Xiansong LU, Dongyan GUO, Fei QIAO. Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery[J]. Journal of Kunming Medical University, 2022, 43(12): 142-146. doi: 10.12259/j.issn.2095-610X.S20221226

Citation:

Xiansong LU, Dongyan GUO, Fei QIAO. Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery[J]. Journal of Kunming Medical University, 2022, 43(12): 142-146. doi: 10.12259/j.issn.2095-610X.S20221226

Citation:

Xiansong LU, Dongyan GUO, Fei QIAO. Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery[J]. Journal of Kunming Medical University, 2022, 43(12): 142-146. doi: 10.12259/j.issn.2095-610X.S20221226

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Comparison of Analgesic Level of Ultrasound-guided Paravertebral，Erector Spinae and Serratus Anterior Plane Blocks in Thoracic Surgery

doi: 10.12259/j.issn.2095-610X.S20221226

Dept. of Anesthesia，The 1st School of Clinical Medicine，Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2022-03-17
Available Online: 2022-11-24
Publish Date: 2022-12-25

Abstract

Abstract

Objective To compare the difference of cutaneous nociceptive block plane of three commonly used nerve blocks （thoracic paravertebral block, erector spinae plane block and serratus anterior plane block） in thoracic surgery, and to identify the optimal nerve block combined with postoperative analgesia for thoracic surgery patients. Methods A total of 75 thoracic patients who underwent thoracoscopic surgery in our hospital were selected and randomly divided into three groups: Thoracic paravertebral nerve block group （T group）, erector spinae plane block group （E group） and serratus anterior plane block group （S group）. Group T: local anesthesia was injected into T7 paravertebral space; Group E: local anesthesia was injected into the fascia layer between the lateral erector spinae muscle and the intercostal muscle of the transverse process of T6 and T7. Group S: local anesthesia was injected into the fascial spaces of the latissimus dorsi and serratus anterior at ribs 6 and 7 in the posterior axillary line. All patients in the three groups were injected with 0.5% ropivacaine hydrochloride （15±3） mL under the guidance of ultrasound to ensure the correct position of the needle tip. After 20 minutes of local anesthetic injection, the anesthetic block effect and plane were measured by needle pricking. Results The block plane of the chest wall （midclavicular line and anterior axillary line） in group T was more extensive than that in group E and group S, the mean values of T group were 12.04 （P < 0.05）, 9.76 （P < 0.05）; while the block range of the thoracic wall （midaxillary line and posterior axillary line） in group S was more extensive, the mean values of S group were 9.8 （P < 0.05）, 10.48 （P < 0.05）. Conclusion For patients undergoing thoracic surgery, especially thoracoscopic surgery, it is more reasonable to use thoracic paravertebral nerve block as an auxiliary method for intraoperative anesthesia and postoperative analgesia. Serratus anterior plane block may be more suitable for breast surgery.
- Thoracic paraspinal nerve block,
- Erector spinae muscle block,
- Serratus anterior muscle block,
- Block plane,
- Thoracic surgery

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References(15)

References

[1]	袁青,崔旭蕾,徐仲煌,等. 超声引导下躯干阻滞的临床应用进展[J]. 临床麻醉学杂志,2017,33(10):1029-1032. doi: 10.3969/j.issn.1004-5805.2017.10.024
[2]	Kim D H,Oh Y J,Lee J G,et al. Efficacy of ultrasound-guided serratus plane block on postoperative quality of recovery and analgesia after video-assisted thoracic surgery:A randomized,triple-blind,placebo-controlled study[J]. Anesthesia and Analgesia:Journal of the International Anesthesia Research Society,2018,126(4):1353-1361.
[3]	Blanco R,Parras T,McDonnell J G,et al. Serratus plane block:A novel ultrasound-guided thoracic wall nerve block[J]. Anaesthesia,2013,68(11):1107-1113.
[4]	费莉,杨建兵. 超声可视下前锯肌平面阻滞在胸腔镜手术镇痛中的应用[J]. 中国医学杂志,2021,23(2):271-274.
[5]	张隆盛,张楷弘,杨铎,等. 老年胸腔镜术后连续前锯肌平面阻滞与胸椎旁阻滞镇痛效果比较[J]. 实用医学杂志,2021,37(5):654-659. doi: 10.3969/j.issn.1006-5725.2021.05.019
[6]	刘福海,申东方. 胸神经阻滞、竖脊肌平面阻滞对乳腺癌患者术后疼痛程度及术后康复指标的影响[J]. 临床医学研究与实践,2022,7(5):91-93. doi: 10.19347/j.cnki.2096-1413.202205027
[7]	涂光洁,吴志林,王洁,等. 超声引导下T₅椎旁神经阻滞联合竖脊肌平面阻滞应用于胸腔镜下肺叶切除术中的效果[J]. 国际麻醉学与复苏杂志,2020,41(11):1039-1042. doi: 10.3760/cma.j.cn321761-20191218-00145
[8]	郑子豪,程静,张中军. 超声引导下竖脊肌平面阻滞与胸椎旁阻滞用于单孔胸腔镜肺叶切除术的镇痛效果比较[J]. 广东医学,2020,41(16):1698-1701. doi: 10.13820/j.cnki.gdyx.20193556
[9]	单涛,谢红,张勇,等. 超声引导下小剂量局麻药外周神经阻滞现状[J]. 临床麻醉学杂志,2017,33(8):822-824. doi: 10.3969/j.issn.1004-5805.2017.08.024
[10]	Richardson J,Jones J,Atkinson R. The effect of thoracic paravertebral blockade on intercostal somatosensory evoked potentials[J]. Anesth Analg,1998,87(2):373-376.
[11]	张竞雄,杨涛,龙彦笑,等. 超声引导下竖脊肌平面阻滞在胸椎手术镇痛中的应用[J]. 广东医学,2020,41(24):2554-2558. doi: 10.13820/j.cnki.gdyx.20201261
[12]	崔杰,杨立荣,张俊伟,等. 超声引导下椎旁阻滞和前锯肌平面阻滞用于肋骨骨折术后镇痛效果的观察[J]. 当代医学,2020,26(13):22-24.
[13]	王娇,许敏,杨静. 超声引导下竖脊肌平面阻滞临床应用及研究进展[J]. 国际麻醉学与复苏杂志,2020,41(3):278-284.
[14]	曾晓平,施宏,吴玮,等. 超声引导下前锯肌平面阻滞的研究进展[J]. 临床麻醉学杂志,2021,37(9):991-993.
[15]	陈韦东,谭炜浩,钟锦涛,等. 胸椎旁阻滞技术的研究进展[J]. 中国临床解剖学杂志,2021,39(1):111-114.

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