The impact of hydromorphone combined with ropivacaine in serratus anterior plane block on postoperative pain in patients undergoing video-assisted thoracoscopic pulmonary lobectomy: a randomized, double-blind clinical trial

作者：Xuefeng Chen, Weifeng Zhang, Lin Wang, WeiBing Wang, Yuhong Li · 发表于：BMC Anesthesiology · 年份：2025 · DOI：10.1186/s12871-025-03101-2 · 被引用次数：3 · 研究领域：Anesthesia and Pain Management、Cancer, Stress, Anesthesia, and Immune Response、Enhanced Recovery After Surgery

BACKGROUND: This study aimed to assess the effects of hydromorphone as an adjuvant to ropivacaine serratus anterior plane block (SAPB) on postoperative analgesia and inflammatory responses in patients undergoing video-assisted thoracoscopic surgery (VATS). METHODS: This was a prospective, randomized, double-blind clinical trial. A total of 120 lung cancer patients, aged 20-75 years, with an American Society of Anesthesiologists classification of I or II and a body mass index of 18-28 kg/m², were randomly assigned to three groups: ropivacaine combined with hydromorphone SAPB (HR group), ropivacaine SAPB (R group), and control (C group). Ultrasound-guided deep SAPB was used to inject medications. The main observed indicators were postoperative visual analog scale (VAS) pain scores, serum inflammatory markers (C-reactive protein (CRP), IL-6, TNF-α), intraoperative medication dosage, postoperative complication rates, and analgesic effects. RESULTS: Postoperative VAS pain scores were significantly reduced in the HR and R groups compared to the C group, especially at 6 h postoperatively. The median VAS score in the HR group was 2.00 (inter-quartile ratio (IQR): 2.00, 2.00), which was significantly lower than that of the C group's score of 3.00 (IQR: 3.00, 3.00; P < 0.001). The CRP levels at 24 and 48 h postoperatively in the HR group were 23.80 mg/L and 21.65 mg/L, respectively, significantly lower than the C group's levels of 56.65 mg/L and 82.75 mg/L, P < 0.001. The levels of IL-...