Application of ultrasound-guided anterior extrapleural space block in robot-assisted thoracoscopic lung surgery.

Objective: To evaluate the perioperative analgesic efficacy of ultrasound-guided anterior extrapleural space block in patients undergoing robot-assisted thoracoscopic lung surgery. Methods: A total of 64 patients scheduled for elective robot-assisted thoracoscopic lung surgery between January 2024 and March 2025 were randomly assigned to two groups: the anterior extrapleural space block combined with general anesthesia group (Group A, n = 32) and the general anesthesia-alone group (Group G, n = 32). The following parameters were recorded: mean arterial pressure (MAP) and heart rate (HR) at baseline (T0, upon entering the operating room), after anesthesia induction (T1), at skin incision (T2), at the start of lung resection (T3), at the end of surgery (T4), and upon leaving the operating room (T5). Intraoperative consumption of anesthetic, time to first postoperative opioid analgesic requirement, Visual Analog Scale (VAS) scores at 12 h, 24 h, and 48 h postoperatively, anesthesia recovery time, operating room exit time, postoperative hospital stay, and adverse events were also documented. Results: At the T2 to T5 time points, Group A exhibited lower MAP and HR values in comparison with Group G (P < 0.05). Group A required substantially smaller dosages of ciprofol and remifentanil during the surgical procedure compared with Group G (P < 0.05). The time to first postoperative opioid analgesia in Group A was longer than that in Group G (P < 0.05). The VAS scores for rest and coughing in Group A were lower than those in Group G at 12 h, 24 h, and 48 h following surgery (P < 0.05). Group A exhibited shorter anesthesia recovery time, shorter time to leave the operating room, and reduced postoperative hospital stay compared to Group G (P < 0.05), with a lower overall incidence of adverse reactions (P < 0.05). Conclusion Ultrasound-guided anterior extrapleural space block delivers effective perioperative analgesia in robot-assisted thoracoscopic lung surgery, reduces intraoperative anesthetic requirements, decreases postoperative opioid demand, and facilitates recovery. [ABSTRACT FROM AUTHOR]