Influence Of Rhomboid Intercostal Block(RIB)on Analgesic Effect In Patients Undergoing Thoracoscopic Radical Resection Of Lung Cancer

Objective:To observe the influence of ultrasound-guided rhomboid intercostal block（RIB）on analgesic effect in patients undergoing thoracoscopic radical resection of lung cancer.Methods:Eighty-six patients（56 males and 30 females,ASA physical status I～III）,who plan to undergo elective radical resection of lung cancer,were distributed to two groups at random,RIB combined with PCIA group（group R）and PCIA group（group P）,n=43 for each group.The local anesthetic used 40 ml of0.3%ropivacaine,the sensory block range was measured by acupuncture every 10 mins after the RIB,it was recorded three times in total.The intraoperative dosage of remifentanil was counted.NRS and BCS were observed at 1 h,6 h,18 h,24 h,48 h after surgery.The frequency for effective compressions of PCIA,the consumption of butorphanol tartrate,the cases of dezocine remedial analgesia,the time and total number of the supplementation of ketorolac tromethamine within 48 h were counted.Complications of block and postoperative adverse reactions were recorded as well.Results:The sensory block range of 31 patients in Group R was in the area innervated by the lateral branch of T₃～T₇intercostal nerve and the posterior branch of thoracic nerve.The other 12 patients had sensory block in the area of T₃～T₈intercostal nerve lateral branch and posterior branch of thoracic nerve.Compared with group P,NRS scores at 6 h,18 h,24 h after surgery significantly was lower（P<0.05）,BCS scores was higher（P<0.05）.In group R,the consumption of remifentanil,butorphanol tartrate,the number of effective PCIA pumps,the frequency of ketorolac tromethamine in 48 h were less than group P（P<0.05）.The first supplementation time of ketorolac tromethamine in group R was significantly longer than group P（P<0.05）.There were 0 case of additional salvage analgesia in group R and 2 cases in group P.No complications after RIB operation and postoperation in group R.No difference in the incidence of reactions in group P and R.Conclusion:Ultrasound-guided rhomboid intercostal block can effectively control intraoperative and postoperative pain after thoracoscopic radical resection of lung cancer,reduce the need for analgesics and improve patients comfort level.