Abstract: Objective The aim of this study was to investigate application of serratus anterior plane block and posterior rectus sheath block under general anesthesia in patients undergoing intrahepatic bile duct stone (IHS) removal. Methods 60 patients with HIS were encountered in our hospital between April 2020 and January 2024, and all underwent surgery operation for removal of the stones under general anesthesia. For analgesia, patients were divided into control (n=28), receiving thoracic paravertebral nerve block, and observation (n=32), receiving serratus anterior plane block and posterior rectus sheath block. Post-anesthesia care unit (PACU) stay and other operation parameters were recorded, Ramsay sedation scores, resting and motion visual analogue scale (VAS) scores, and quality of recovery-40 questionnaire (QoR-40) were assessed. Results PACU stay in the observation was (35.1±2.0)min, much shorter than [(40.3±2.1)min,P＜0.05] in the control; by 2 and 24 hours after operation, resting VAS scores in the observation were(2.9±1.4)points and (2.5±1.1)points, both significantly lower than [(3.7±1.7)points and (3.3±1.4)points, respectively, P＜0.05], and motion VAS scores were (3.7±1.6)points and (2.9±1.5)points, both significantly lower than [(4.4±1.5)points and (3.6±1.4)points, P＜0.05] in the control; pain perception, physical comfort and postoperative QoR-40 score in the observation were (35.3±1.2)points, (52.8±2.3)points and (175.0±8.0)points, all significantly higher than [(28.4±1.5)points, (45.8±2.8) points and (165.1±9.7)points, respectively, P＜0.05] in the control. Conclusion In patients with HIS undergoing surgery operation for removal of stones under general anesthesia, serratus anterior plane block and posterior rectus sheath block have a satisfactory analgesic effects, and improve quality of recovery.

Key words: Intrahepatic bile duct stones, General anesthesia, Serratus anterior plane block, Posterior rectus sheath block, Analgesia