Zhang Teng-Jiao, Zhang Jing-Jing, Qu Zong-Yang, Zhang Hong-Ye, Qiu Yong, Hua Zhen
Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing, People's Republic of China.
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
J Pain Res. 2020 Apr 5;13:709-717. doi: 10.2147/JPR.S248171. eCollection 2020.
Erector spinae plane block (ESPB) is a newly reported interfascial plane block in pain management, and it can block the nerves exactly in line with the area of the posterior lumbar surgery. The objective of this research was to determine the effectiveness of pre-operative ESPB in enhancing recovery of posterior lumbar surgery.
A total of 60 patients undergoing open posterior lumbar decompression surgery under general anesthesia were randomized into two groups. T12 group was performed pre-operatively bilateral ESPB with ropivacaine at the T12 level, but control group did not receive the block. The primary outcome was the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score at 10 minutes after extubation. Secondary outcomes included intraoperative sufentanil consumption, postoperative morphine consumption, first time to ambulation after surgery and hospital length of stay after surgery. All participants were followed up to hospital discharge.
The mean (SD) MOAA/S scores at 10 minutes after extubation were 4.2 (95% CI, 4.0 to 4.4), and 3.4 (95% CI, 3.2 to 3.6) in the T12 and control groups (P <0.001), respectively. Intraoperative sufentanil consumption (P =0.007) and postoperative morphine consumption (P =0.003) were lower in the T12 group than in the control group. Although first time to ambulation after surgery was sooner in the T12 group than in the control group (P =0.003), hospital length of stay was similar (P=0.054).
Pre-operative bilateral ESPB at T12 can enhance recovery after posterior lumbar surgery and reduce perioperative opioid consumption.
竖脊肌平面阻滞（ESPB）是疼痛管理中一种新报道的筋膜间平面阻滞，它能准确阻滞与腰椎后路手术区域一致的神经。本研究的目的是确定术前ESPB对促进腰椎后路手术恢复的有效性。
总共60例在全身麻醉下接受开放性腰椎后路减压手术的患者被随机分为两组。T12组在术前于T12水平用罗哌卡因进行双侧ESPB，而对照组未接受该阻滞。主要结局是拔管后10分钟的改良警觉/镇静状态观察者评估（MOAA/S）评分。次要结局包括术中舒芬太尼用量、术后吗啡用量、术后首次下床活动时间和术后住院时间。所有参与者随访至出院。
T12组和对照组拔管后10分钟的平均（标准差）MOAA/S评分分别为4.2（95%可信区间，4.0至4.4）和3.4（95%可信区间，3.2至3.6）（P<0.001）。T12组术中舒芬太尼用量（P =0.007）和术后吗啡用量（P =0.003）低于对照组。虽然T12组术后首次下床活动时间比对照组早（P =0.003），但住院时间相似（P=0.054）。
术前T12双侧ESPB可促进腰椎后路手术后的恢复并减少围手术期阿片类药物的用量。
