Effect of ultrasound-guided anterior serranus plane block combined with general anesthesia on postoperative analgesia and lung function in patients with thoracoscopic lobectomy for lung cancer

doi:10.3877/cma.j.issn.1674-6902.2025.05.020

Abstract

Abstract:

Objective

To analyze the perioperative therapeutic effectiveness of an ultrasound-guided serratus anterior plane block integrated within a multimodal anesthetic regimen in lung cancer patients undergoing thoracoscopic lobectomy.

Methods

A total of 87 lung cancer patients who underwent thoracoscopic lobectomy in our hospital from January 2020 to December 2024 were selected as the subjects. Based on anesthesia protocols, patients were systematically allocated into two distinct study cohorts: an observation group comprising 41 patients and a control group containing 46 patients. The control group received ultrasound-guided thoracic paravertebral nerve block, while the observation group underwent ultrasound-guided serratus anterior plane blockade targeting the surgical side as part of their anesthetic management. Respiratory parameters, postoperative analgesia, pulmonary function, perioperative medication use and anesthesia-related adverse effects were compared between the two groups.

Results

In the observation group, T₁ oxygenation index (PaO₂/FiO₂) (149.32±28.95) mmHg, T₂ PaO₂/FiO₂(318.72±41.25) mmHg, T₃ PaO₂/FiO₂(354.83±48.76) mmHg, forced vital capacity (FVC) (2.14±0.46) L, forced expiratory volume in one second (FEV₁) (1.84±0.36)L, and maximal mid-expiratory flow curve (MMF) (1.43±0.31) L/s were higher than those in the control group (134.53±20.16)mmHg, (298.26±37.45) mmHg, (328.21±41.29) mmHg, (1.85±0.41) L, (1.68±0.31) L, (1.25±0.33) L/s, respectively. The observation group showed lower T₁ alveolar-arterial oxygen tension difference (A-aDO₂) (369.83±45.34) mmHg, T₂ A-aDO₂ (314.53±36.35) mmHg, T₃ A-aDO₂ (284.25±34.39)mmHg, 12-hour resting visual analogue scale (VAS) score (2.32±0.43) points, 24-hour resting VAS score (3.19±0.51) points, 12-hour coughing VAS score (2.97±0.61) points, 24-hour coughing VAS score (3.63±0.85) points, and total sufentanil consumption (104.34±16.32) μg compared to the control group (397.54±52.29) mmHg, (335.69±39.87) mmHg, (305.62±41.23) mmHg, (2.52±0.45) points, (3.56±0.58) points, (3.31±0.62) points, (4.15±0.89) points, (112.56±18.19) μg, respectively. The first patient controlled analgesia (PCIA) demand time in the observation group (7.62±1.12) h was later than that in the control group (7.09±1.08)h. The number of effective PCIA compressions in the observation group at 48 h (2.67±0.82) times was significantly lower than that in the control group (3.26±0.95) times (P<0.05).

Conclusions

The analgesic effect of ultrasound-guided serratus anterior plane block combined with general anesthesia is good. It is helpful to improve the lung function of patients, reduce the use of perioperative drugs, which is of clinical significance.

Key words: Bronchogenic carcinoma, Serratus anterior plane block, General anesthesia, Thoracoscopy, Lobectomy

Liang Wu, Qingqing Shi, Hailong Xu, Haicheng Jiang, Jian Li, Zhijing Song, Panpan Zhao. Effect of ultrasound-guided anterior serranus plane block combined with general anesthesia on postoperative analgesia and lung function in patients with thoracoscopic lobectomy for lung cancer[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 773-778.

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URL: https://zhfbjbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6902.2025.05.020

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References 30

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临床指标	组别	例数	T₀	T₁	T₂	T₃
PaCO₂	观察组	41	40.59±5.34	49.67±4.87^a	46.34±4.06^a	43.61±4.75
	对照组	46	41.23±5.51	52.36±4.19^a	48.59±4.12^a	46.34±7.14
	t值		0.549	2.769	2.560	2.073
	P值		0.585	0.007	0.012	0.041
PaO₂/FiO₂	观察组	41	384.52±48.72	149.32±28.95^a	318.72±41.25^a	354.83±48.76^a
	对照组	46	394.53±51.58	134.53±20.16^a	298.26±37.45^a	328.21±41.29^a
	t值		0.927	2.789	2.425	2.757
	P值		0.356	0.007	0.017	0.007
A-aDO₂	观察组	41	256.32±28.65	369.83±45.34^a	314.53±36.35^a	284.25±34.39^a
	对照组	46	264.17±33.63	397.54±52.29^a	335.69±39.87^a	305.62±41.23^a
	t值		1.165	2.625	2.575	2.607
	P值		0.247	0.010	0.012	0.011

临床指标	组别	例数	T₀	T₁	T₂	T₃
PaCO₂	观察组	41	40.59±5.34	49.67±4.87^a	46.34±4.06^a	43.61±4.75
	对照组	46	41.23±5.51	52.36±4.19^a	48.59±4.12^a	46.34±7.14
	t值		0.549	2.769	2.560	2.073
	P值		0.585	0.007	0.012	0.041
PaO₂/FiO₂	观察组	41	384.52±48.72	149.32±28.95^a	318.72±41.25^a	354.83±48.76^a
	对照组	46	394.53±51.58	134.53±20.16^a	298.26±37.45^a	328.21±41.29^a
	t值		0.927	2.789	2.425	2.757
	P值		0.356	0.007	0.017	0.007
A-aDO₂	观察组	41	256.32±28.65	369.83±45.34^a	314.53±36.35^a	284.25±34.39^a
	对照组	46	264.17±33.63	397.54±52.29^a	335.69±39.87^a	305.62±41.23^a
	t值		1.165	2.625	2.575	2.607
	P值		0.247	0.010	0.012	0.011

组　别	例数	FVC(L)		FEV₁(L)		MMF(L/s)
组　别	例数	术前	术后	术前	术后	术前	术后
观察组	41	3.56±0.54	2.14±0.46^a	2.98±0.51	1.84±0.36^a	2.46±0.51	1.43±0.31^a
对照组	46	3.68±0.58	1.85±0.41^a	2.86±0.55	1.68±0.31^a	2.41±0.48	1.25±0.33^a
t值		0.995	3.109	1.051	2.227	0.471	2.613
P值		0.323	0.003	0.296	0.029	0.639	0.011

组　别	例数	FVC(L)		FEV₁(L)		MMF(L/s)
组　别	例数	术前	术后	术前	术后	术前	术后
观察组	41	3.56±0.54	2.14±0.46^a	2.98±0.51	1.84±0.36^a	2.46±0.51	1.43±0.31^a
对照组	46	3.68±0.58	1.85±0.41^a	2.86±0.55	1.68±0.31^a	2.41±0.48	1.25±0.33^a
t值		0.995	3.109	1.051	2.227	0.471	2.613
P值		0.323	0.003	0.296	0.029	0.639	0.011

组　别	例数	ALT(U/L)		Scr(mmol/L)		GLU(mmol/L)
组　别	例数	术前	术后24 h	术前	术后24 h	术前	术后24 h
观察组	41	32.12±4.25	46.68±6.78^a	72.39±10.53	80.59±12.53^a	5.02±0.61	5.61±0.64^a
对照组	46	33.05±4.32	50.19±6.29^a	74.05±11.45	84.22±14.92^a	5.06±0.66	5.93±0.67^a
t值		1.010	2.505	0.701	1.221	0.292	2.271
P值		0.315	0.014	0.485	0.226	0.771	0.026

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