Effect Of Continuous Serratus Anterior Plane Block On Postoperative Pulmonary Oxygenation Function In Patients With Radical Resection Of Lung Cancer Under Thoracoscopic Surgery

Objective To compare the efficacy of continuous serratus anterior plane block and patient-controlled intravenous analgesia in reducing pulmonary complications and improving pulmonary oxygenation function in patients with radical resection of lung cancer under thoracoscopic surgery.To observe whether continuous SAPB is more effective in reducing postoperative pulmonary complications and adverse reactions and improving pulmonary oxygenation function,and whether it can play a positive role in promoting the rapid recovery of postoperative patients.Methods We enrolled 126 patients?age 18-70 years old,gender unlimited?,18.5-30kg/m²BMI,ASA grade?-?,undergoing thoracoscopic radical resection of lung cancer.Patients were randomly divided into two groups:continuous serratus anterior plane block group?group S,n=63?and patient-controlled intravenous analgesia group?group P,n=63?.In group S,serratus anterior plane block was guided by ultrasound after surgery,with 20 ml of 0.375%ropivacaine for the first dose which followed by a continuous infusion of 0.2%ropivacaine.In group P,patient-controlled intravenous analgesia was received after surgery with continuous infusion of sufentanil.To record the arterial oxygen partial pressure?Pa O₂?and calculate the oxygenation index?OI?,using OI=Pa O₂/Fi O₂.Blood samples from radial artery were taken for blood gas analysis at following points:before anesthesia?T₀?,end of surgery?T₁?,2 h?T₂?,6 h?T₃?and 24 hours after extubation of tracheal tube?T₄?.Postoperative resting and active visual analogue scale?VAS?were recorded at T₂,T₃and T₄.And the rescue analgesia of patients were recorded.The operative methods,perioperative indexes and the intraoperative use of anesthesia drugs?sufentanil,remifentanil and propofol?were recorded.The incidence of postoperative pulmonary complications?pneumonia,atelectasis,hypoxemia,respiratory failure?and adverse reactions?nausea,vomiting?were observed and recorded.Results Compared with group P,the OI in group S at T₂,T₃and T₄were significantly higher?P<0.05?.There was no difference in OI between the two groups at T₀?P>0.05?.Compared with T₀,there was no significant difference in OI between the two groups at T₁?P>0.05?,but the OI at T₂and T₃were obviously declined?P<0.05?.At T₄,the OI in group S has returned to T₀level?P>0.05?,while the OI in group P was still below than the T₀level?P<0.05?.The VAS scores at T₂,T₃and T₄were lower in group S than in group P?P<0.05?.Compared with group P,the incidence of atelectasis,hypoxemia,nausea and vomiting in group S was significantly lower?P<0.05?.But there was no difference in the incidence of pneumonia between the two groups?P>0.05?.There was no difference in the other parameters between the two groups.Conclusion Compared with patient-controlled intravenous analgesia,continuous serratus anterior plane block can reduce postoperative VAS score,reduce postoperative pulmonary complications and adverse reactions,improve postoperative oxygenation index,accelerate the recovery of postoperative pulmonary oxygenation function of patients after thoracoscopic radical resection of lung cancer,and accelerate postoperative rehabilitation.