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竖脊肌平面阻滞用于乳腺手术的完全手术麻醉和术后镇痛:30例前瞻性可行性研究

Erector spinae plane block for complete surgical anaesthesia and postoperative analgesia for breast surgeries: A prospective feasibility study of 30 cases.

作者信息

Malawat Aman, Verma Kalpana, Jethava Durga, Jethava Dharam D

机构信息

Department of Anaesthesiology, Critical Care and Pain Management, Mahatma Gandhi Medical College and Hospital, RIICO Institutional Area, Sitapura, Jaipur, Rajasthan, India.

出版信息

Indian J Anaesth. 2020 Feb;64(2):118-124. doi: 10.4103/ija.IJA_639_19. Epub 2020 Feb 4.

Abstract

BACKGROUND AND AIMS

Several regional anaesthesia techniques have been described for carcinoma of the breast surgeries in the past but all of them failed to provide adequate surgical anaesthesia and are associated with multiple complications, thus limiting their use. This prospective study was designed to assess the efficacy of erector spinae plane (ESP) block to provide complete surgical anaesthesia without general anaesthesia (GA) and postoperative analgesia in patients undergoing modified radical mastectomy (MRM) surgery.

METHODS

Thirty females of the American Society of Anaesthesiologists physical status I, II or III scheduled for MRM were included in the study to receive unilateral ultrasound-guided ESP block preoperatively (25 ml of 0.5% bupivacaine with dexamethasone 8 mg on the operating side). The primary objective of the study was to evaluate the efficacy of ESP block to provide complete surgical anaesthesia in terms of total number of cases converted to GA.

RESULTS

Our study shows that ultrasound-guided single-shot ESP block provided complete surgical anaesthesia in all the patients within an average of 31.50 minutes and an average long-lasting postoperative analgesia of 41.73 hours following MRM.

CONCLUSION

Our study proves that ESP block is a novel, predictable, secure, and safe option for carcinoma of the breast surgery. Thus, ESP block would surely provide a clinical advantage in these population group.

摘要

背景与目的

过去已描述了多种用于乳腺癌手术的区域麻醉技术,但所有这些技术都未能提供充分的手术麻醉,且伴有多种并发症,因此限制了它们的应用。本前瞻性研究旨在评估竖脊肌平面(ESP)阻滞在接受改良根治性乳房切除术(MRM)的患者中提供无需全身麻醉(GA)的完全手术麻醉及术后镇痛的效果。

方法

本研究纳入了30例美国麻醉医师协会身体状况为I、II或III级且计划接受MRM的女性患者,术前接受单侧超声引导下的ESP阻滞(患侧注射25毫升含8毫克地塞米松的0.5%布比卡因)。本研究的主要目的是根据转为GA的病例总数评估ESP阻滞提供完全手术麻醉的效果。

结果

我们的研究表明,超声引导下单次ESP阻滞在平均31.50分钟内为所有患者提供了完全手术麻醉,且在MRM术后平均提供了41.73小时的长效术后镇痛。

结论

我们的研究证明,ESP阻滞是乳腺癌手术一种新颖、可预测、可靠且安全的选择。因此,ESP阻滞肯定会在这些人群中提供临床优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9075/7017659/f0ae73173ac5/IJA-64-118-g001.jpg

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