Rispoli Marco, Tamburri Roberta, Nespoli Moana Rossella, Esposito Marianna, Mattiacci Dario Maria, Santonastaso Domenico Pietro, Casazza Dino, Amore Dario, Corcione Antonio
Anesthesia and ICU, Vincenzo Monaldi Hospital, Naples, Italy.
Department of Anesthesiology and Intensive Care, Luigi Vanvitelli University, Naples, Italy.
Tumori. 2020 Oct;106(5):388-391. doi: 10.1177/0300891620915783. Epub 2020 Apr 24.
Erector spine plane block (ESPB) is a newly defined regional anesthesia technique performed by injection of local anesthetic beneath the erector spine muscle. We tested ESPB as a regional rescue analgesia bedside technique to be performed in the thoracic surgical ward, reporting a 7-patient case series.
We report our experience in rescue analgesia after thoracic surgery. During the postoperative stay, numeric rating scale (NRS) score >3 and inability to perform physiotherapy or effective cough due to postoperative pain represented the criteria for proposing rescue analgesia with ESPB. NRS at rest and during movements was recorded; blood gas analysis and spirometry were performed to evaluate PaO/FiO (P/F), forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV) before ESPB execution. After performing the ESPB, static and dynamic NRS, P/F, and FVC and FEV were recorded at 40 minutes and 80 minutes.
NRS had a reduction at rest and in dynamic assessment. The P/F did not improve but spirometric measures improved. FVC had a relevant improvement only after 80 minutes; FEV was increased after 40 minutes.
The use of ESPB as postoperative rescue analgesia can offer several advantages due to effective rescue analgesia and safety that makes it easy to perform in the thoracic surgical ward or in an outpatient clinic setting.
竖脊肌平面阻滞（ESPB）是一种新定义的区域麻醉技术，通过在竖脊肌下方注射局部麻醉剂来实施。我们测试了ESPB作为一种可在胸外科病房床边进行的区域补救镇痛技术，并报告了一个7例患者的病例系列。
我们报告了我们在胸外科手术后补救镇痛方面的经验。在术后住院期间，数字评分量表（NRS）评分>3以及因术后疼痛无法进行物理治疗或有效咳嗽是提出采用ESPB进行补救镇痛的标准。记录静息和活动时的NRS；在实施ESPB前进行血气分析和肺功能测定，以评估氧合指数（PaO/FiO，P/F）、用力肺活量（FVC）和第1秒用力呼气量（FEV）。实施ESPB后，在40分钟和80分钟记录静态和动态NRS、P/F以及FVC和FEV。
静息和动态评估时NRS均降低。P/F没有改善，但肺功能测定指标有所改善。FVC仅在80分钟后有显著改善；FEV在40分钟后增加。
ESPB作为术后补救镇痛方法使用，因其有效的补救镇痛和安全性而具有诸多优势，便于在胸外科病房或门诊环境中实施。
