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| Analgesic effect of serratus anterior plane combined with rectus sheath block in open hepatocellular carcinoma resection |
| CAI Yuping CHEN Yuren CHEN Xiao XU Deming LIN Xinqiang |
| Department of Anesthesiology, Affiliated Hospital of Putian University, Fujian Province, Putian 351100, China |
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Abstract Objective To study the analgesic effect of serratus anterior plane block combined rectus sheath block in patients undergoing radical operation of hepatic carcinoma. Methods A total of 60 liver cancer patients admitted to Affiliated Hospital of Putian University from October 2019 to May 2021 were selected as the research subjects, and they were divided into group S (n=30) and group C (n=30) according to random number table method. Group S was treated with serratus anterior muscle plane combined with rectus sheath nerve block combined with general anesthesia, while group C was treated with general anesthesia alone. Mean arterial pressure (MAP), heart rate (HR) and surgical volume index (SPI) were compared between the two groups before (T1), 5, 30 and 60 min after (T2-T4) and after (T5). Visual analogue scale (VAS) scores at rest and cough were compared between the two groups at 2, 6, 12 and 24 h postoperatively. The total amount of remifentanil, the pressing times of intravenous controlled analgesia (PCIA) within 12 and 24 h after operation and the incidence of postoperative adverse reactions were compared between the two groups. Results There were no significant differences in MAP, HR and SPI between two groups at T1, T5 (P>0.05). HR, MAP and SPI at T2-T5 were higher than those at T1, the differences were statistically significant (P<0.05). HR, MAP and SPI of T2-T4 in group S were lower than those in group C, and the differences were statistically significant (P<0.05). In the resting state, the VAS score of group S was lower than that of group C at 6 and 12 h after surgery, the difference was statistically significant (P<0.05). Under cough condition, VAS score of group S was lower than that of group C at 6, 12 and 24 h after operation, with statistical significance (P<0.05). The amount of Remifentanil in group S and the times of PCIA pressing 12 and 24 h after operation were less than those in group C, the differences were statistically significant (P<0.05). The total incidence of adverse reaction in group S was lower than that in group C, and the difference was statistically significant (P<0.05). Conclusion Serratus anterior plane block combined with rectus sheath block can effectively reduce surgical stress and the dosage of opioids with open hepatectomy, stabilize hemodynamic changes, provide definite analgesic effects, reduce the incidence of complications, and promote patients rapid recovery ,worthy of clinical research and application.
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