关键词: 肋间神经阻滞； 局部浸润阻滞； 术后恢复质量； 术后镇痛

Abstract: Objective To evaluate the effects of thoracoscopic intercostal nerve block and incision infiltration block on postoperative recovery quality and analgesia in patients with partial pulmonary resection.Methods From July 2023 to December 2023, 60 patients scheduled for elective thoracoscopic partial lung resection were divided into two groups by random number table method, with 30 cases in each group.The observation group underwent thoracoscopic vision intercostal nerve block,and the control group underwent incision local infiltration block.Intravenous patient-controlled analgesia was adopted in all cases after the operation.The 15-item Recovery Quality Scale (QOR-15) score was recorded 1 day before surgery,24 hours and 48 hours after surgery.The visual analogue pain scores (VAS) at rest and cough at 2,4,8,24,and 48 hours after surgery,consumption of sufentanil within 24 hours and 48 hours after surgery,remedial analgesia and related adverse reactions were recorded.Results The QOR-15 scores of the observation group at 24 hours and 48 hours after operation were (103.4±14.2) and (111.2±6.9),which were higher than those of the control group (91.3±21.4) and (101.8±14.8),and the differences were statistically significant (P<0.05).At rest,the VAS scores of the observation group at 2,4,8 and 24 hours after surgery were (2.0±0.9),(2.1±0.9),(2.5±1.2) and (2.4±1.2).Compared with the control group (3.1±1.2),(3.4±1.7),(3.5±1.7) and (3.2±1.3),the differences were statistically significant (P<0.05).When coughing,the VAS scores of the observation group at 2,4 and 8 hours after operation were (2.4±0.6),(2.5±0.6) and (3.0±1.2),which were lower than (3.2±1.2),(3.7±1.7) and (4.0±2.1) of the control group.The difference was statistically significant (P<0.05).The consumption of sufentanil within 24 hours and 48 hours after surgery in the observation group was (58.1 ± 7.5)μg and (116.5 ± 14.9)μg,respectively,which were lower than those in the control group (63.2 ± 8.5)μg and (125.0 ± 16.7)μg,and the difference was statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion Compared with incision infiltration block,thoracoscopic intercostal nerve block has better postoperative analgesic effect and higher postoperative recovery quality.

Key words: intercostal nerve block;incision infiltration block;postoperative recovery quality； postoperative analgesia