HIỆU QUẢ GIẢM ĐAU SAU MỔ CỦA PHONG BẾ MẶT PHẲNG GIỮA CƠ LIÊN SƯỜN VÀ CƠ TRÁM TRONG PHẪU THUẬT CẮT PHỔI CÓ NỘI SOI HỖ TRỢ

Abstract

Objective: Evaluation of Postoperative Analgesic Efficacy of Rhomboid Intercostal Plane Block (RIPB) with 20ml of 0.25% Levobupivacaine in Patients Undergoing Video-Assisted Thoracoscopic (VATS) Pulmonary Resection. Subjects and Methods: A randomized controlled clinical study was conducted on 60 patients indicated for video-assisted lobectomy/segmentectomy from December 2024 to July 2025 at K Tan Trieu Hospital. Patients were divided into two groups: Group 1 (with RIPB block and IV-PCA) and Group 2 (only IV-PCA). Monitored parameters included VAS scores at rest, during movement, coughing, and postoperative morphine requirements. Results: Pain relief efficacy in Group 1 was significantly superior: VAS scores in Group 1 were statistically significantly lower at most evaluation time points during rest, movement, and coughing (p < 0.05). Total postoperative morphine consumption in Group 1 was significantly lower at 24 hours (4.0 ± 2.4 mg vs 23.7 ± 9.2 mg, p < 0.001) and 48 hours (13.6 ± 3.8 mg vs 36.8 ± 11.7 mg, p < 0.001). The time to the first rescue morphine dose in Group 1 was markedly longer (12.2 ± 5.5 hours vs 0.3 ± 0.2 hours, p < 0.001). Conclusion: The rhomboid intercostal plane block is an effective and safe pain relief technique for patients undergoing video-assisted lung resection. This method significantly reduces morphine consumption, improves the quality of pain relief, and is safe with minimal side effects. It provides anesthesiologists with an additional option for multimodal perioperative pain management.