Optimizing anesthesia for thoracoscopic surgical ablation of atrial fibrillation: efficacy of serratus anterior plane block combined with general anesthesia
10.3760/cma.j.cn131073.20240322.01014
- VernacularTitle:胸腔镜下外科房颤消融术麻醉的优化：SAPB联合全身麻醉的效果
- Author:
Chanjuan GONG
1
;
Yu CHEN
;
Yin FANG
;
Jian SHEN
;
Xiaodong CHEN
Author Information
1. 南京医科大学第一附属医院 江苏省人民医院麻醉与围术期医学科，南京 210029
- Keywords:
Thoracoscopes;
Atrial fibrillation;
Radiofrequency ablation;
Anesthesia, general;
Serratus anterior plane block
- From:
Chinese Journal of Anesthesiology
2024;44(10):1221-1224
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the optimization effects of serratus anterior plane block (SAPB) combined with general anesthesia for thoracoscopic surgical ablation of atrial fibrillation (TSAAF).Methods:Eighty American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex, aged >18 yr, with a body mass index of 18-30 kg/m 2, scheduled for elective TSAAF, were randomly assigned to either SAPB combined with general anesthesia group (SG group) or general anesthesia group (G group), with 40 cases in each group. SG group received ultrasound-guided bilateral SAPB with 0.375% ropivacaine 20 ml each before surgery, while G group did not receive block before operation. Both groups underwent general anesthesia. The time to the first analgesia pump use, the number of successfully delivered doses and requirement for rescue analgesia within 48 h after operation were recorded. Inspiratory spirometry was measured at preoperative day 1 (T 0), at the time of discharge from the recovery room (T 1), and at 24 and 48 h after operation (T 2, 3). The extubation time was also recorded. The usage of intraoperative remifentanil, norepinephrine and ephedrine, duration of recovery room stay, and occurrence of recurrent atrial fibrillation, delirium, respiratory depression, and nausea/vomiting within 48 h after operation, and length of postoperative hospital stay were recorded. Results:Compared to G group, the time to the first analgesia pump use was significantly prolonged, the number of successfully delivered doses was reduced within 48 h after operation, the rate of rescue analgesia was decreased, inspiratory spirometry was increased at T 1-3, the extubation time and length of postoperative hospital stay were shortened, and the recurrence rate of atrial fibrillation was decreased within 48 h after surgery in SG group ( P<0.05). No significant differences were found between the two groups regarding the intraoperative remifentanil consumption, usage rate of vasoactive drugs, and incidence of postoperative nausea/vomiting, delirium and respiratory depression ( P>0.05). Conclusions:Combination of SAPB and general anesthesia can effectively improve the postoperative analgesic effect and is helpful for the recovery in the patients undergoing TSAAF.
