Effect of ultrasound-guided second serratus anterior plane block on postoperative analgesia after thoracoscopic partial lung resection

LIU Hong-qiang; CHENG Lei; ZHENG Wei

doi:10.11659/jjssx.11E025044

您当前的位置：

首页 >

文章列表页 >

Effect of ultrasound-guided second serratus anterior plane block on postoperative analgesia after thoracoscopic partial lung resection

Intelligent Anesthesia and Perioperative Strategies | 更新时间：2026-06-16

- Effect of ultrasound-guided second serratus anterior plane block on postoperative analgesia after thoracoscopic partial lung resection
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 6, Pages: 474-477(2026)
- 作者机构：
  
  1.孝感市中心医院/武汉科技大学附属孝感医院麻醉科，湖北孝感 432000
  2.孝感市中心医院/武汉科技大学附属孝感医院胸心外科，湖北孝感 432000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.11E025044
  CLC： R614.4
- Received：07 November 2025，
  
  Published：25 June 2026
- 稿件说明：
移动端阅览
刘宏强,程蕾,郑威.超声引导下前锯肌平面二次阻滞对胸腔镜下肺部分切除术后镇痛的影响[J].局解手术学杂志,2026,35(06):474-477.

LIU Hong-qiang,CHENG Lei,ZHENG Wei.Effect of ultrasound-guided second serratus anterior plane block on postoperative analgesia after thoracoscopic partial lung resection[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(06):474-477.
刘宏强,程蕾,郑威.超声引导下前锯肌平面二次阻滞对胸腔镜下肺部分切除术后镇痛的影响[J].局解手术学杂志,2026,35(06):474-477. DOI： 10.11659/jjssx.11E025044.

LIU Hong-qiang,CHENG Lei,ZHENG Wei.Effect of ultrasound-guided second serratus anterior plane block on postoperative analgesia after thoracoscopic partial lung resection[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(06):474-477. DOI： 10.11659/jjssx.11E025044.

摘要

目的

探讨超声引导下前锯肌平面二次阻滞对胸腔镜手术患者术后镇痛效果、恢复质量及炎症反应的影响。

方法

选取2022年8月至2023年6月在孝感市中心医院择期行胸腔镜手术的86例患者，采用随机数字表法分为前锯肌平面阻滞（SAPB）组（

=43）与对照组（

=43）。2组患者术中均接受首次超声引导下SAPB；术后24 h，SAPB组患者在超声引导下接受前锯肌平面二次阻滞，对照组患者则在相同位置注射等量生理盐水。比较2组患者术前24 h及术后48 h、72 h的生活质量恢复问卷（QoR-40）评分，术后24 h、48 h、72 h的疼痛数字评定量表（NRS）评分，术后48 h内舒芬太尼用量，术后24 h、48 h、72 h的血清白细胞介素-6（IL-6）与白细胞介素-10（IL-10）水平，以及术后并发症和不良反应发生率。

结果

对重复测量数据进行方差分析表明，QoR-40评分在组别、时间及交互作用上均具有统计学意义（

0.05）。事后检验发现，SAPB组患者术后48 h、72 h的QoR-40评分均显著高于对照组（

0.05）。在疼痛控制方面，NRS评分在组别、时间及交互作用上均具有统计学意义（

0.001），SAPB组患者术后48 h的NRS评分及舒芬太尼用量均显著低/少于对照组（

0.05）。在炎症反应方面，SAPB组患者术后48 h、72 h的IL-6水平显著低于对照组（

0.01），而IL-10水平显著高于对照组（

0.01）

。

2组患者术后并发症及不良反应发生率比较，差异均无统计学意义（

0.05）。

结论

对于接受胸腔镜手术的患者，在术后24 h实施超声引导下的前锯肌平面二次阻滞，能有效延长术后镇痛时间，改善术后恢复质量，减少阿片类药物的用量，并有助于减轻机体的术后炎症反应，促进患者康复。

Abstract

Objective

To investigate the effects of ultrasound-guided second serratus anterior plane block （SAPB） on postoperative analgesia， recovery quality， and inflammatory response in patients undergoing thoracoscopic surgery.

Methods

A total of 86 patients who underwent elective thoracoscopic surgery in Xiaog

an Central Hospital from August 2022 to June 2023 were selected and randomly divided into the serratus anterior plane block （SAPB） group（

=43） and the control group （

=43） by random number table method. All patients in both groups received the first ultrasound-guided SAPB during surgery. At 24 hours postoperatively， patients in the SAPB group received a ultrasound-guided second SAPB， while patients in the control group were injected with an equal volume of normal saline at the same site. The quality of recovery-40 （QoR-40） scores at 24 hours preoperatively， 48 hours and 72 hours postoperatively， numerical rating scale （NRS） scores of pain at 24 hours， 48 hours， 72 hours postoperatively， sufentanil consumption within 48 hours postoperatively， and serum levels of interleukin-6 （IL-6）　and interleukin-10 （IL-10）， as well as the incidences of postoperative complications and adverse reactions were compared between the two groups.

Results

Variance analysis of repeated measures data showed significant differences in the groups， time， and interaction effects for QoR-40 total scores （

0.05）. Post-hoc tests revealed that the QoR-40 scores at 48 hours and 72 hours postoperatively in the SAPB group were significantly higher than those in the control group （

0.05）. Regarding pain control，the NRS scores showed statistically significant differences in group， time， and interaction （

0.001）. The NRS scores at 48 hours postoperatively and sufentanil consumption in the SAPB group were significantly lower/less than those in the control group（

0.05）. In terms of inflammatory response， the IL-6 levels at 48 hours and 72 hours postoperatively in the SAPB group were significantly lower than those in the control group（

0.01）， while the IL-10 levels were significantly higher than those in the control group（

0.01）. There was no statistically significant

difference in the incidence of postoperative complications or adverse reactions between the two groups （

0.05）.

Conclusion

For patients undergoing thoracoscopic surgery， performing ultrasound-guided second SAPB at 24 hours postoperatively can effectively prolong postoperative analgesia duration， improve postoperative recovery quality， reduce opioid consumption，alleviate postoperative inflammatory response， thereby promoting patient rehabilitation.

关键词

Keywords

references

Neustein SM ， Mccormick PJ . Postoperative analgesia after minimally invasive thoracoscopy：what should we do？［J］. Can J Anaesth ， 2011 ， 58 （ 5 ）： 423 - 427 . doi： 10.1007/s12630-011-9475-9 http://dx.doi.org/10.1007/s12630-011-9475-9 .

Wildgaard K ， Ringsted TK ， Hansen HJ ， et al . Persistent postsurgical pain after video-assisted thoracic surgery--an observational study ［J］. Acta Anaesthesiol Scand ， 2016 ， 60 （ 5 ）： 650 - 658 . doi： 10.1111/aas.12681 http://dx.doi.org/10.1111/aas.12681 .

Blanco R ， Parras T ， Mcdonnell JG ， et al . Serratus plane block：a novel ultrasound-guided thoracic wall nerve block ［J］. Anaesthesia ， 2013 ， 68 （ 11 ）： 1107 - 1113 . doi： 10.1111/anae.12344 http://dx.doi.org/10.1111/anae.12344 .

Park MH ， Kim JA ， Ahn HJ ， et al . Arandomised trial of serratus anterior plane block for analgesia after thoracoscopic surgery ［J］. Anaesthesia ， 2018 ， 73 （ 10 ）： 1260 - 1264 . doi： 10.1111/anae.14424 http://dx.doi.org/10.1111/anae.14424 .

Shariat A ， Bhatt H . Successful use of serratus plane block as primary anesthetic for video-assisted thoracoscopic surgery （VATS）-assisted pleural effusion drainage ［J］. J Cardiothorac Vasc Anesth ， 2018 ， 32 （ 1 ）： e31 - e32 . doi： 10.1053/j.jvca.2017.10.038 http://dx.doi.org/10.1053/j.jvca.2017.10.038 .

Omindo W ， Ping W ， Qiu R ， et al . Efficacy of ultrasound-guided second serratus anterior plane block on postoperative quality of recovery and analgesia after video-assisted thoracic surgery：arandomized，triple-blind，placebo-controlled study ［J］. J Thorac Dis ， 2024 ， 16 （ 7 ）： 4195 - 4207 . doi： 10.21037/jtd-23-982 http://dx.doi.org/10.21037/jtd-23-982 .

Bebdixen M ， Jorgensen OD ， Kronborg C ， et al . Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer：arandomised controlled trial ［J］. Lancet Oncol ， 2016 ， 17 （ 6 ）： 836 - 844 . doi： 10.1016/S1470-2045（16）00173-X http://dx.doi.org/10.1016/S1470-2045（16）00173-X .

Wurnig PN ， Lacker H ， Teiner C ， et al . Is intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia？［J］. Eur J Cardiothorac Surg ， 2002 ， 21 （ 6 ）： 1115 - 1119 . doi： 10.1016/s1010-7940（02）00117-3 http://dx.doi.org/10.1016/s1010-7940（02）00117-3 .

Chen N ， Qiao Q ， Chen R ， et al . The effect of ultrasound-guided intercostal nerve block，single-injection erector spinae plane block and multiple-injection paravertebral block on postoperative analgesia in thoracoscopic surgery：arandomized，double-blinded，clinical trial ［J］. J Clin Anesth ， 2020 ， 59 ： 106 - 111 . doi： 10.1016/j.jclinane.2019. 07.002 http://dx.doi.org/10.1016/j.jclinane.2019.07.002 .

孟杰，肖航，曾宪伟，等 . 超声引导下前锯肌平面阻滞对胸腔镜肺癌根治术术后镇痛及炎性反应的影响［J］. 临床肺科杂志， 2018 ， 23 （ 5 ）： 913 - 916 . doi： 10.3969/j.issn.1009-6663.2018. 05.038 http://dx.doi.org/10.3969/j.issn.1009-6663.2018.05.038 .

孙晶，郑江波，朱俊峰 . 超声引导下单次前锯肌平面阻滞对胸腔镜患者术后镇痛效应及炎性反应的影响［J］. 中华生物医学工程杂志， 2019 ， 25 （ 5 ）： 590 - 593 . doi： 10.3760/cma.j.issn.1674-1927. 2019.05.014 http://dx.doi.org/10.3760/cma.j.issn.1674-1927.2019.05.014 .

Hanley C ， Wall T ， Bukowsk I ， et al . Ultrasound-guided continuous deep serratus anterior plane block versus continuous thoracic paravertebral block for perioperative analgesia in videoscopic-assisted thoracic surgery ［J］. Eur J Pain ， 2020 ， 24 （ 4 ）： 828 - 838 . doi： 10.1002/ejp.1533 http://dx.doi.org/10.1002/ejp.1533 .

Kim DH ， Oh YJ ， Lee JG ， et al . Efficacy of ultrasound-guided serratus plane block on postoperative quality of recovery and analgesia after video-assisted thoracic surgery：arandomized，triple-blind，placebo-controlled study ［J］. Anesth Analg ， 2018 ， 126 （ 4 ）： 1353 - 1361 . doi： 10.1213/ANE.0000000000002779 http://dx.doi.org/10.1213/ANE.0000000000002779 .

宗雨，谢言虎，胡利国，等 . 超声引导下前锯肌平面阻滞对胸腔镜下肺叶切除术患者术后镇痛的影响［J］. 天津医药， 2019 ， 47 （ 2 ）： 163 - 166 . doi： 10.11958/20181314 http://dx.doi.org/10.11958/20181314 .

Khalil AE ， Abdallah NM ， Bashandy GM ， et al . Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain ［J］. J Cardiothorac Vasc Anesth ， 2017 ， 31 （ 1 ）： 152 - 158 . doi： 10.1053/j.jvca.2016.08.023 http://dx.doi.org/10.1053/j.jvca.2016.08.023 .

Beloeil H ， Gentili M ， Benhamou D ， et al . The effect of a peripheral block on inflammation-induced prostaglandin E2 and cyclooxygenase expression in rats ［J］. Anesth Analg ， 2009 ， 109 （ 3 ）： 943 - 950 . doi： 10.1213/ane.0b013e3181aff25e http://dx.doi.org/10.1213/ane.0b013e3181aff25e .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Analgesic effects of descending ladder type serratus anterior plane block after radical breast cancer surgery

Comparative analysis of Exoview and Mimics three-dimensional reconstruction in thoracoscopic pulmonary segmentectomy

Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery

Application of 4K fluorescence single-port thoracoscopic anatomical segmentectomy in small pulmonary nodules

Application of dexmedetomidine combined with ropivacaine for quadratus lumborum block at the lateral supra-arcuate ligament in open hepatocellular carcinoma resection

Related Author

LIU Wei

XIA Wei

GAO Fang

WANG Chun-xia

QIAO Zhen

YANG Sheng-hui

GUO Zhi-gang

SHI Jia-xing

Related Institution

Department of Anesthesiology,Bozhou Peoples Hospital

Department of Anesthesiology,First Affiliated Hospital of Wannan Medical College/Yijishan Hospital

Operating Room，Xingtai General Hospital，North China Medical and Health Group

Department of Thoracic Surgery，Xingtai General Hospital，North China Medical and Health Group

Department of Anesthesiology，Nanjing Drum Tower Hospital Group Suqian Hospital

⁰