Objective To evaluate the effect of continuous rhomboid intercostal block (CRIB) in postoperative analgesia of patients with thoracoscopic surgery.
Methods A total of 120 patients with thoracoscopic surgery were randomly divided into CRIB group, single rhomboid intercostal block group (SRIB group) and patient-controlled intravenous analgesia group (PCIA group), with 40 cases in each group. Patients in the CRIB group received CRIB before leaving the operating room, patients in the SRIB group received SRIB before leaving the operating room, and patients in the PCIA group were asked to connect PCIA analgesia pump before leaving the operating room. At 1 hour, 2, 6, 12 and 24 hours after surgery, the Visual Analogue Scale (VAS) was used to assess the postoperative pain level of patients in both static and active conditions. At 24 hours after surgery, the 40-item Quality of Recovery Scale (QoR-40) was used to assess the patient's postoperative recovery quality. The number of cases with rescue analgesia within 24 hours after surgery, the time of the first rescue analgesia, the stay time in post-anesthesia care unit (PACU) and the postoperative hospital stay were recorded. Incidence conditions of adverse reactions such as postoperative nausea and vomiting (PONV), dizziness, pruritus, pneumothorax and dyspnea were recorded.
Results Finally, 118 patients were included, including 39 cases in the CRIB group, 39 cases in the SRIB group, and 40 cases in the PCIA group. The VAS scores of patients at 2 hours after surgery in the SRIB group under static and active conditions were significantly lower than those in the CRIB and the PCIA groups (P < 0.05). The VAS scores of patients at 12 and 24 hours after surgery in the CRIB group in both static and active conditions were significantly lower than those in the SRIB and the PCIA groups (P < 0.05). The VAS scores of patients in the CRIB and SRIB groups at each time point under active condition were significantly lower than those in the PCIA group (P < 0.05). The VAS scores of patients at 12 and 24 hours after surgery under active condition in the SRIB group were significantly lower than those in the PCIA group (P < 0.05). The total scores of QoR-40 in the CRIB and the SRIB groups at 24 hours after surgery were significantly higher than that in the PCIA group, while the total score of QoR-40 in the CRIB group at 24 hours after surgery was significantly higher than that in the SRIB group (P < 0.05). The number of cases with rescue analgesia in the CRIB group was significantly less than that in the SRIB and PCIA groups (P < 0.05). The time of the first rescue analgesia in the CRIB group was significantly longer than that in the SRIB and PCIA groups (P < 0.05). The incidence rates of PONV, dizziness and pruritus in the PCIA group were significantly higher than those in the CRIB and SRIB groups (P < 0.05).
Conclusion CRIB is an analgesic method with good postoperative analgesic effect, which can improve the quality of recovery after thoracoscopic surgery.
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