Objective To investigate the postoperative analgesic effect of ropivacaine intercostal nerve block after thoracoscopic lobectomy. Methods A total of 95 patients who underwent thoracoscopic lobectomy under general anesthesia from January 2023 to January 2024 were selected. According to random number table method, 47 cases in the experimental group were treated with ropivacaine intercostal nerve block, and 48 cases in the control group were treated with erector spinae plane block. The two groups were compared in terms of intraoperative vital signs [heart rate (HR) and mean arterial pressure (MAP)] at selected time points, pain at rest and coughing within 48 h after surgery [by numerical rating scale (NRS)], and postoperative recovery. Results Before the block, there was no significant difference in HR and MAP between the two groups (P>0.05). After induction of intubation, at skin incision, and extubation, the MAP and HR in the experimental group were lower than those in the control group (P<0.05). The NRS scores at rest and coughing at 1, 3, 6, and 12 h after surgery in the experimental group were lower than those in the control group (P<0.05). The time of first oral feeding, time of flatus, time of getting out of bed, and days of hospitalization after surgery in the experimental group were significantly shorter than those in the control group (P<0.05). Conclusion Ropivacaine intercostal nerve block could yield better anagesic effect for patients undergoing thoracoscopic lobectomy than erector spinae plane block, and can facilitate postoperative recovery.
CHEN Fangyi
,
CHEN Qiaohui
,
SU Dongfeng
,
DAI Li
. Effect of intercostal nerve block with ropivacaine on postoperative analgesia after thoracoscopic lobectomy[J]. Surgical Research and New Technique, 2025
, 14(1)
: 35
-38
.
DOI: 10.3969/j.issn.2095-378X.2025.01.007
[1] Zhu C, Fang J, Yang J, et al.The role of ultrasound-guided multipoint fascial plane block in elderly patients undergoing combined thoracoscopic-laparoscopic esophagectomy: a prospective randomized study[J]. Pain Ther, 2023, 12(3): 841-852.
[2] Yeung JH, Gates S, Naidu BV, et al. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy[J].Cochrane Database Syst Rev, 2016, 2(2): CD009121.
[3] 胡礼宏,徐霞,沈韦羽,等. 胸腔镜下胸椎旁阻滞在单孔胸腔镜肺叶切除术镇痛中的应用[J]. 中华医学杂志,2020,100(33):2596-2600.
[4] 王凯,李宝强,葛磊,等. 超声引导下罗哌卡因联合艾司氯胺酮椎旁阻滞技术在胸腔镜肺叶切除术中的应用价值[J]. 生物医学工程与临床,2023,27(3):310-315.
[5] She H, Wu B, Mao S, et al.Effects of different anesthesia methods on perioperative immune function and long-term regression of patients undergoing thoracoscopic radical esophagectomy for esophageal cancer[J]. Heliyon, 2023, 9(12): e22822.
[6] Davakis S, Syllaios A, Mpaili E, et al.Minimally invasive oesophagectomy and emerging complications: intercostal lung hernia[J]. Ann R Coll Surg Engl, 2020, 102(3): e73-e74.
[7] Jin L, Yao R, Heng L, et al.Ultrasound-guided continuous thoracic paravertebral block alleviates postoperative delirium in elderly patients undergoing esophagectomy: a randomized controlled trial[J]. Medicine (Baltimore), 2020, 99(17):e19896.
[8] 张隆盛,蓝金辛,林耿彬,等. 复方倍他米松复合罗哌卡因胸椎旁阻滞用于胸腔镜术后镇痛的效果[J]. 临床麻醉学杂志,2024,40(4):368-372.
[9] 张伶,方静. 麻醉诱导前30 mL罗哌卡因ESPB对非小细胞肺癌胸腔镜肺叶切除术患者术后镇痛效果观察[J]. 山东医药,2023,63(24):53-56.
[10] Kingma BF, Eshuis WJ, de Groot EM, et al. Paravertebral catheter versus EPidural analgesia in Minimally invasive Esophageal resectioN: a randomized controlled multicenter trial (PEPMEN trial)[J]. BMC Cancer, 2020, 20(1): 142.
[11] Zhang W, Cong X, Zhang L, et al.Effects of thoracic nerve block on perioperative lung injury,immune function, and recovery after thoracic surgery[J]. Clin Transl Med. 2020, 10(3): e38.
[12] Boisen ML, Schisler T, Kolarczyk L, et al.The year in thoracic anesthesia: selected highlights from 2019[J]. J Cardiothorac Vasc Anesth, 2020, 34(7): 1733-1744.