Analgesic effect of ultrasound-guided intercostal muscle plane block of external oblique muscle in endoscopic pancreaticoduodenectomy
10.3760/cma.j.cn431274-20231101-00492
- VernacularTitle:超声引导腹外斜肌肋间肌平面阻滞在腔镜胰十二指肠切除术中的镇痛效果
- Author:
Xiuxiu ZHAO
1
;
Yong ZHANG
1
;
Qian ZHAO
1
;
Yuzhi JIANG
1
;
Hongwei SHI
1
;
Hongguang BAO
1
;
Hongyu WANG
1
Author Information
1. 南京医科大学附属南京医院 南京市第一医院麻醉疼痛与围术期医学科，南京 210006
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Laparoscopy;
Nerve block;
External oblique intercostal muscle plane block;
Analgesia
- From:
Journal of Chinese Physician
2025;27(1):28-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the analgesic effect of intercostal muscle plane block of external oblique muscle in patients undergoing endoscopic pancreaticoduodenectomy.Methods:A total of 48 patients undergoing endoscopic pancreaticoduodenectomy under elective general anesthesia in Nanjing First Hospital from February to July 2023 were prospectively selected and divided into two groups ( n=24) according to random number table method: abdominal external oblique intercostal muscle plane block combined with general anesthesia group (EG group) and general anesthesia group (G group). The EG group was blocked in the intercostal muscle plane of the external oblique muscle before general anesthesia induction, and 0.375% ropivacaine 20 ml was injected on both sides, respectively. Patient-controlled intravenous analgesia (PCIA) was performed in both groups after operation, and the pain Visual Analogue Scale (VAS) score was less than 4 points. When the VAS score was ≥4, 1 mg oxycodone was injected intravenously for relief and analgesia. VAS scores at 30 min (T 0), 6 h (T 1), 12 h(T 2), 24 h(T 3), 48 h(T 4) after extubation, intraoperative drug and fluid dosage, postoperative sleep quality, analgesic satisfaction score, remedial analgesia and the occurrence of adverse reactions were recorded. Results:The scores of rest and exercise VAS at T 0, T 1, T 2, T 3 and T 4 in the EG group were significantly lower than those in the G group (all P<0.05). The dosage of norepinephrine, propofol, remifentanil and total fluid infusion in the EG group were significantly lower than those in the G group (all P<0.05). The sleep quality and analgesic satisfaction of the EG group were better than those of the G group (all P<0.05), the first time of PCIA compression after surgery was longer than that of the G group ( P<0.05), the number of effective compressions, the amount of oxycodone relief and analgesia, the proportion of nausea and vomiting, and the stay time of anesthesia intensive care unit (AICU) were lower than those of the G group (all P<0.05). There was no significant difference in total hospital stay between the two groups ( P>0.05). Conclusions:Compared with general anesthesia alone, abdominal external oblique intercostal muscle plane block combined with general anesthesia in patients with endoscopic pancreaticoduodenectomy has significant postoperative analgesia effect, which can not only reduce postoperative VAS score and opioid consumption, but also improve sleep quality and increase postoperative analgesia satisfaction. Ultrasound-guided intercostal muscle plane block of external oblique muscle can be used as a better analgesic method in endoscopic pancreaticoduodenectomy.
