Bilateral transversus thoracis muscle plane block provides effective analgesia and enhances recovery after open cardiac surgery
Bilateral transversus thoracis muscle plane block provides effective analgesia and enhances recovery after open cardiac surgery
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DOI：
10.1111/jocs.15666
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发表时间：
2021-05-28
影响因子：
1.6
通讯作者：
Chen, Shibiao
中科院分区：
文献类型：
--
作者：
Zhang, Yang;Li, Xianzhi;Chen, Shibiao
背景胸骨中段是心脏直视手术后疼痛的主要来源。为探讨双侧胸横肌平面(TTMP)阻滞在心内直视手术中的作用，将60例患者随机分为两组：双侧TTMP阻滞组(TP组)和非神经阻滞组(CO组)。主要终点是围手术期舒芬太尼的用量。次要观察指标包括术后疼痛、氟比洛芬酯的应用、拔管后的睡眠质量、拔管时间、胃肠功能恢复时间、拔管时间、重症监护病房(ICU)住院时间和住院时间。结果TP组舒芬太尼和氟比洛芬酯的用量显著低于CO组。在拔管后1、2、6、12、24 h，CO组静息和活动时的NRS评分均高于TP组。与CO组相比，TP组拔管时间、首次排便时间、ICU住院时间和住院时间均显著缩短。TP组拔管后两晚睡眠质量明显优于TP组。结论双侧TTMP阻滞可为心内直视手术患者提供良好的围术期镇痛，促进术后恢复。
Background The mid-sternum is the main source of pain after open cardiac surgery. The aim of this study was to investigate the effect of bilateral transversus thoracis muscle plane (TTMP) blocks on open cardiac surgery.Methods Sixty patients were randomly divided into two groups: bilateral TTMP blocks (TP group) or no nerve block (CO group). The primary endpoint was perioperative sufentanil consumption. The secondary outcome measures included postoperative pain, flurbiprofen axetil administration, quality of sleep after extubation, time to extubation, time to the return of gastrointestinal function, time to drain removal, the Intensive Care Unit (ICU) stay time, and hospital stay.Results The TP group reported significantly less sufentanil and flurbiprofen axetil consumption than the CO group. The CO group had higher Numerical Rating Scale (NRS) pain scores at 1, 2, 6, 12, and 24 h after extubation both at rest and during movement than the TP groups. Compared with the CO group?time to extubation, time to the first bowel movement, ICU stay time, and hospital stay were significantly decreased in the TP group. The TP group was rated as better in the quality of the two nights of sleep after extubation.Conclusion Bilateral TTMP blocks can provide good perioperative analgesia for patients undergoing open cardiac surgery and promote postoperative recovery.