2025 年第 5 期 第 20 卷

前锯肌平面阻滞在直视微创冠状动脉旁路移植术中的应用

Application of serratus anterior plane block in minimally invasive direct coronary artery bypass grafting surgery

作者：袁可欣崔博群马骏

英文作者：Yuan Kexin Cui Boqun Ma Jun

单位：首都医科大学附属北京安贞医院麻醉手术中心，北京100029

英文单位：Department of Anesthesiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：前锯肌平面阻滞；加速康复外科；直视微创冠状动脉旁路移植术；术后镇痛

英文关键词：Serratusanteriorplaneblock;Enhancedrecoveryaftersurgery;Minimallyinvasivedirectcoronaryarterybypassgrafting;Postoperativeanalgesia

• 摘要：

• 随着加速康复外科的发展，多模式镇痛在微创心脏外科手术中扮演着越来越重要的角色，胸壁神经阻滞的应用日益广泛。其中前锯肌平面阻滞被认为是一种安全且有效的胸壁神经阻滞方法，但这种技术目前在心脏外科手术中的应用十分有限。由于直视微创冠状动脉旁路移植术（MIDCAB）中对肋间组织的牵拉作用，临床上对优质的镇痛要求更高。本文对前锯肌平面阻滞在MIDCAB中的研究现状与进展进行了综述。介绍了前锯肌平面阻滞在MIDCAB中的研究背景及其重要性，阐述了前锯肌平面阻滞在MIDCAB中的操作方法，介绍了国内外在该领域的研究现状和特点。我们通过比较国内外研究，综述目前前锯肌平面阻滞在微创心脏外科手术应用中的优势和不足,并对其未来的应用进行了展望。

• With the development of enhanced recovery after surgery, multimodal analgesia plays an increasingly important role in minimally invasive cardiac surgery, and chest wall nerve block is increasingly used. Serratus anterior plane block is considered to be a safe and effective method for chest wall nerve block, but its application in cardiac surgery is very limited. Due to the traction effect of intercostal tissue in minimally invasive direct coronary artery bypass grafting (MIDCAB), high quality analgesia is required in clinical practice. This article reviews the research status and progress of serratus anterior plane block in MIDCAB, introduces the research background and importance of serratus anterior plane block in MIDCAB, describes the operation method of serratus anterior plane block in MIDCAB, and introduces the research status and characteristics of this field at home and abroad. By comparing domestic and foreign research, this article summarizes the advantages and disadvantages of anterior serratus muscle plane block in minimally invasive cardiac surgery, and looks forward to its future applications.