Sensory Assessment and Block Duration of Deep Parasternal Intercostal Plane Block in Patients Undergoing Cardiac Surgery: A Prospective Observational Study.
Sensory Assessment and Block Duration of Deep Parasternal Intercostal Plane Block in Patients Undergoing Cardiac Surgery: A Prospective Observational Study.
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DOI：
10.1007/s40122-022-00403-y
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发表时间：
2022-09
期刊：
影响因子：
4
通讯作者：
Chen, Shibiao
中科院分区：
文献类型：
--
作者：
Zhang, Yang;Min, Jia;Chen, Shibiao
关键词：
在心脏手术中，使用胸骨旁深肋间平面（PIP）阻滞作为多模式镇痛方案的补充越来越受到关注。本研究的目的是观察心脏直视手术患者深PIP阻滞的皮肤感觉阻滞分布及其持续时间。这项观察性、前瞻性临床研究包括113名参与者。所有患者均在超声引导下用0.33%罗哌卡因40 ml行双侧PIP深阻滞。主要研究结果是接受心脏直视手术的患者中深部PIP阻滞的皮肤感觉阻滞分布。次要结局包括所有参与者的阻滞持续时间。在深度PIP阻滞结束后30 min，通过使用冷刺激（冰块）测试皮肤感觉阻滞的面积。拔管后每小时进行一次皮肤感觉测试，直到恢复正常感觉。双侧深PIP阻滞后30 min，T4 ~ T6皮节阻滞成功率几乎为100%。然而，T2（左侧T2阻滞百分比：64.6%;右侧T2阻滞百分比：42.5%）和T3（左侧T3阻滞百分比：88.5%;右侧T3阻滞百分比：87.6%）的成功率较低。少数患者在T1或T7出现皮节阻滞（左侧T1阻滞百分比：7.08%;右侧T1阻滞百分比：2.65%;左侧T7阻滞百分比：6.19%;右侧T7阻滞百分比：10.6%）。PIP深度阻滞的平均有效时间为17 h。双侧深PIP阻滞可产生广泛的皮肤感觉阻滞，在胸骨中部具有可变的皮节分布，持续相当长的有效时间。本研究已在中国临床试验注册中心（ChiCTR 2100047755）注册。
There has been increasing interest in using deep parasternal intercostal plane (PIP) block as a supplement to multimodal analgesia regimens in cardiac surgery. The aim of this study was to observe cutaneous sensory block distribution and its duration for deep PIP blocks in patients undergoing open cardiac surgery. This observational, prospective clinical study consisted of 113 participants. All patients received bilateral ultrasound-guided deep PIP block with 40 ml 0.33% ropivacaine. The primary study outcome was cutaneous sensory block distribution of deep PIP blocks in patients undergoing open cardiac surgery. Secondary outcome included block duration in all participants. The area of cutaneous sensory block was tested by using a cold stimulus (ice cube) 30 min after the end of deep PIP block administration. Cutaneous sensory testing was performed once every hour after extubation until the return of normal sensation. Thirty minutes after bilateral deep PIP block administration, the successful block rate of dermatomes T4 to T6 was almost 100%. However, T2 (percentage of left T2 block: 64.6%; percentage of right T2 block: 42.5%) and T3 (percentage of left T3 block: 88.5%; percentage of right T3 block: 87.6%) had a lower percentage of success. A few patients had blocked dermatomes at T1 or T7 (percentage of left T1 block: 7.08%; percentage of right T1 block: 2.65%; percentage of left T7 block: 6.19%; percentage of right T7 block: 10.6%). The mean effective duration of the deep PIP block was 17 h. Bilateral deep PIP blocks can produce a widespread cutaneous sensory blockade with variable dermatomal distribution in the mid-sternum for a considerable effective duration. This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100047755).
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