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大胆探讨:是否应将 ESP 阻滞重新命名为 RIP II 阻滞?

Daring discourse: should the ESP block be renamed RIP II block?

机构信息

Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden

Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

Reg Anesth Pain Med. 2021 Jan;46(1):57-60. doi: 10.1136/rapm-2020-101822. Epub 2020 Sep 14.

Abstract

During the time period 1984 to the turn of the millennium, interpleural nerve blockade was touted as a very useful regional anesthetic nerve blockade for most procedures or conditions that involved the trunk and was widely practiced despite the lack of proper evidence-based support. However, as an adequate evidence base developed, the interest for this type of nerve block dwindled and very few centers currently use it-thereby to us representing the rest in peace (RIP) I block. Unfortunately, we get a sensation when we observe the current fascination with the erector spinae plane block (ESPB), which since 2019 has generated as many as 98 PubMed items. This daring discourse point out the lack of a proper evidence base of the ESPB compared with other established nerve blocking techniques as well as the lack of a proven mechanism of action that explains how this nerve block technique can be effective regarding surgical procedures performed on the front of the trunk. Emerging meta-analysis data also raise concern and give cause to healthy skepticism regarding the use of ESPB for major thoracic or abdominal surgery. Against this background, we foresee that ESPB (and variations on this theme) will end up in a similar fashion as interpleural nerve blockade, thereby soon to be renamed the RIP II block.

摘要

在 1984 年至千禧年之交的这段时间里,肋间神经阻滞被吹捧为一种非常有用的区域麻醉神经阻滞技术,适用于涉及躯干的大多数手术或情况,尽管缺乏适当的基于证据的支持,但这种神经阻滞技术得到了广泛的应用。然而,随着适当证据基础的发展,人们对这种神经阻滞的兴趣逐渐减少,目前只有很少的中心使用它——因此,我们将其称为安息神经阻滞(RIP)II 块。不幸的是,当我们观察到人们对竖脊肌平面阻滞(ESPB)的当前兴趣时,我们会感到一种感觉,自 2019 年以来,已有多达 98 篇 PubMed 文章涉及到这种阻滞。这种大胆的论述指出了 ESPB 与其他已建立的神经阻滞技术相比,缺乏适当的证据基础,也缺乏能够解释这种神经阻滞技术如何在躯干前部进行手术时有效的作用机制。新兴的荟萃分析数据也对 ESPB 在胸大或腹部手术中的应用提出了担忧,并引发了合理的怀疑。有鉴于此,我们预计 ESPB(和这个主题的变体)将以类似于肋间神经阻滞的方式结束,因此很快将被重新命名为安息神经阻滞(RIP)II 块。

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