Effect Of Ultrasound-guided Serratus Anterior Plane Block Combined With Patient-controlled Intravenous Analgesia On Postoperative Recovery Quality Of Patients Undergoing Open Hepatectomy

Objective: To explore the effect of ultrasound-guided serratus anterior plane block combined with patient-controlled intravenous analgesia on postoperative analgesia and recovery quality in patients undergoing open hepatectomy.Methods: According to the inclusion and exclusion standard,120 patients with open liver resection were enrolled.They were divided to two groups.SAPB combined with PCIA group(Group S)and PCIA group(Group D),60 cases in each group.Sufentanil0.1 μ g / kg was used at the beginning of abdominal closure in both groups for postoperative analgesia.Group S received SAPB at the 7th and 8th intercostal space of the right axillary midline after the operation,and 10 ml of 0.375% ropivacaine was injected at two points respectively.Group D did not receive any treatment.PCIA was used for postoperative analgesia in both groups.Ramsay sedation score and VAS pain score within 48 hours after operation were recorded,and the rescue analgesia situation of the patients was recorded;the pressing times of analgesia pump and the dosage of sufentanil at 0-2 h,2-6 h,6-12 h,12-24 h and 0-24 h after operation were recorded;the Qo R-15 scores of the two groups at first day before operation,first day and third day and fifth day after operation were recorded;the perioperative liver function indexes of the patients were recorded;the clinical symptoms were recorded Postoperative exhaust time,how long was the patients away from bed,postoperative hospital stay;postoperative adverse reactions.Results: In group S,1 case of unplanned laparotomy,1 case of operation time > 5h,3cases need blood transfusion to be eliminated;in group D,1 case of PACU transfer delay,4 cases need blood transfusion to be eliminated,a total of 110 patients were included in the statistical results,55 cases in group S and 55 cases in group D respectively.(1)Compared with group D,the VAS of group S was significantly lower at 2 h,6 h and 12 h after operation(P < 0.05).(2)There were 10 cases(18.2%)in group S and 18 cases(32.7%)in group D(P > 0.05).(3)Compared with group D,the number of PCA and the dosage of sufentanil in group S were significantly lower at 2-6h,6-12 h,12-24 h and 0-24 h after operation.(4)For Qo R-15,there was only significant difference between the two groups on the first day and the third day after operation,which was significantly higher in group S than that in group D(P < 0.05).(5)There was not significant difference in liver function between the two groups(P > 0.05).(6)The exhaust time,first time out of bed and postoperative hospital stay in group S were significantly shorter than those in group D(P < 0.05).(7)Compared with group D,the number of patients with postoperative feel sick and emesis in group S was significantly reduced(P < 0.05).Conclusion: Ultrasound guided serratus anterior plane block is helpful to reduce postoperative pain,improve postoperative recovery quality and shorten postoperative hospital stay in patients with open hepatectomy on the basis of patient-controlled intravenous analgesia.