Application of Precise Intercostal Nerve Block for Postoperative Analgesia in Single-port Television-assisted Thoracoscopic Surgery

BAI Chengyun; LI Zhongcheng; LI Wenjun; LIU Yang; HU Jianguo; SHA Chuang

doi:10.14033/j.cnki.cfmr.2025.27.013

Abstract：Objective:To evaluate the efficacy of a precision intercostal nerve block for postoperative analgesia in single-port television-assisted thoracoscopic surgery.Method:100 patients who underwent single-hole TV-assisted thoracoscopic surgery in the Affiliated Hospital of Qinghai University from January 2022 to January 2023 were selected as the study subjects,and randomly divided into the precise intercostal nerve block(PINB)group and the local infiltration anesthesia(LIA)group,with 50 cases in each group.Pain levels were assessed in the patients'quiet state and deep breathing state in the post-anesthesia recovery room(PACU)(T1),1 h after leaving the PACU(T2),4 h(T3),12 h(T4),and 24 h(T5).The quality of patients'postoperative recovery was assessed at the T5 time point using the 40-item Quality of Recovery Rating Scale(QoR-40).The number of patient controlled intravenous analgesia(PCIA)pump presses and the number of remedial analgesia were recorded for each postoperative period.The time of the first remedial analgesia,patient agitation during awakening,delayed awakening,chills,and the occurrence of adverse reactions such as postoperative nausea and vomiting(PONV),dizziness,skin itching,and hypoxemia during the 24 h postoperative period were recorded.Result:The visual analog scale(VAS)scores at the T2 time point during deep breathing were lower in the PINB group than in the LIA group,and the difference was statistically significant(P<0.05).The VAS at rest and at the T3 time point during deep breathing was lower in the PINB group than in the LIA group,and the difference was statistically significant(P<0.05).The scores of comfort category and pain category in QoR-40 in PINB group were higher than that in LIA group at 24 h after operation,and the difference was statistically significant(P<0.05).The number of PCIA presses and the number of remedial analgesia in PINB group in the time period of T1～T3 was less than that in LIA group,and the difference was statistically significant(P<0.05).The time of the first remedial analgesia in PINB group was shorter than that in LIA group,and the difference was statistically significant(P<0.05).Conclusion:Precision intercostal nerve block provides excellent postoperative analgesia with a high degree of safety in patients undergoing single-port television-assisted thoracoscopic surgery.