Analgesic Effectiveness of Truncal Plane Blocks in Patients Undergoing the Nuss Procedure: A Randomized Controlled Trial.

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY Pain and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-18 DOI:10.1007/s40122-024-00627-0
Tao Chen, Yu Xu, Yu Chen, Shibiao Chen, Yang Zhang
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Abstract

Introduction: Most patients undergoing the Nuss procedure reported moderate to severe pain after surgery. This study aimed to investigate the efficacy and safety of ultrasound-guided serratus anterior plane block (SAPB) combined with transversus thoracic muscle plane (TTMP) block for relieving acute pain in patients undergoing the Nuss procedure.

Methods: The enrolled patients in our study were allocated to either receive combined nerve blocks with ropivacaine (NB group) or saline (CON group). The primary outcome of this study was postoperative pain at 2, 4, 8, 16, 24, 36, and 48 h during rest and movement (coughing). Secondary outcomes included intraoperative dosage of remifentanil, the time to extubation and the length of stay in the post-anesthesia care unit (PACU), the total acetaminophen and codeine tablet consumption, time to first bowel movement, time to first flatus, opioid-related adverse events, and the length of hospital stay.

Results: Patients in the NB group had significantly lower Numerical Rating Scale (NRS) pain scores compared with the CON group. The NB group required significantly less postoperative acetaminophen consumption and lower dosages of perioperative sufentanyl and remifentanil compared with the CON group. The length of stay in the PACU and time to extubation were significantly increased in the CON group compared with the NE group. Time to first bowel movement and time to first flatus were earlier in the NB group. But there were no significant differences between the groups in terms of the length of hospital stay and codeine tablet consumption.

Conclusion: Ultrasound-guided SAPB and TTMP blocks in patients undergoing the Nuss procedure could provide effective analgesia.

Trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000038506).

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对接受努斯手术的患者进行截骨平面阻滞的镇痛效果:随机对照试验
导言大多数接受努斯手术的患者在术后都会出现中度至重度疼痛。本研究旨在探讨超声引导下的前锯肌平面阻滞(SAPB)与胸横肌平面阻滞(TTMP)联合用于缓解努斯手术患者急性疼痛的有效性和安全性:本研究的入组患者被分配接受罗哌卡因联合神经阻滞(NB 组)或生理盐水(CON 组)。本研究的主要结果是术后 2、4、8、16、24、36 和 48 小时休息和运动(咳嗽)时的疼痛。次要结果包括术中瑞芬太尼用量、拔管时间、麻醉后护理病房(PACU)停留时间、对乙酰氨基酚和可待因片剂总用量、首次排便时间、首次排便时间、阿片类药物相关不良事件以及住院时间:NB组患者的数字评分量表(NRS)疼痛评分明显低于CON组。与CON组相比,NB组术后对乙酰氨基酚的用量明显更少,围手术期舒芬太尼和瑞芬太尼的用量也更低。与 NE 组相比,CON 组在 PACU 的住院时间和拔管时间明显增加。NB组的首次排便时间和首次排气时间更早。但在住院时间和可待因片用量方面,两组之间没有明显差异:结论:在超声引导下对接受努氏手术的患者进行 SAPB 和 TTMP 阻滞可提供有效的镇痛效果:本研究已在中国临床试验注册中心注册(ChiCTR2000038506)。
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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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