SO SÁNH HIỆU QUẢ PHONG BẾ MẶT PHẲNG CƠ RĂNG TRƯỚC VỚI PHONG BẾ THẦN KINH NGỰC TRONG PHẪU THUẬT LỒNG NGỰC CÓ NỘI SOI HỖ TRỢ

Abstract

Objectives: 1. Compare the effectiveness of Serratus anterior plane block (SAPB) with Pectoral nerve block (PEC II) with Ropivacaine 0.375% 15ml in Video assisted thoracic surgery (VAT). 2. Side-effects of two methods. Methods: Clinical intervention study, randomized and controlled on 62 patients undergoing VATS surgery, divided into 2 groups under ultrasound-guided anesthesia with Ropivacaine 0.375% 15ml before surgery: group I: SAPB, group II: PEC II. Routine anesthesia, after extubation with PCA morphine analgesia for both groups when VAS >4, data were coded and processed according to statistical methods. Research results: SAPB and PEC II anesthesia under ultrasound guidance are simple and easy to perform. The time of onset of action, the circumference of the block did not differ between the two groups, but SAPB had better axillary block, and PEC II had better sternal block. The duration of action of SAPB was 434 ± 134 min. significantly longer than PEC II 197 ± 86 minutes. SAPB and PEC II were equally effective for pain relief during and after VATS surgery. The amount of fentanyl during surgery, the amount of morphine after surgery, the average VAS score at rest/exercise/cough in 72 hours after surgery in the two groups had no statistically significant differences. Time to first morphine request was significantly delayed in the SAPB group by 6.2±1.3 hours compared with 3.3±1.1 hours in the PEC II group with respect to duration of action. Side effects of the 2 groups are low and not dangerous. Conclusion: SAPB group had the same effectiveness in reducing pain during and after VATS surgery as PEC II but had a longer duration of action.