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竖脊肌平面阻滞与腹横肌平面阻滞用于剖宫产术后镇痛:一项前瞻性随机对照研究。

Erector spinae plane block and transversus abdominis plane block for postoperative analgesia in cesarean section: A prospective randomized comparative study.

作者信息

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

机构信息

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

出版信息

J Anaesthesiol Clin Pharmacol. 2020 Apr-Jun;36(2):201-206. doi: 10.4103/joacp.JOACP_116_19. Epub 2020 Jun 15.

Abstract

BACKGROUND AND AIMS

Erector spinae plane (ESP) block is an interfascial plane block given at the paraspinal region and provides effective visceral and somatic analgesia. Transversus abdominis plane (TAP) block is also an interfascial block that provides adequate somatic pain control. We conducted this study to compare the analgesic efficacy of ESP and TAP blocks with ropivacaine for 48 h after the cesarean section.

MATERIAL AND METHODS

Sixty patients scheduled for elective cesarean section under spinal anesthesia, randomly divided into ESP block ( = 30) or TAP block ( = 30) groups. After completion of surgery, ultrasound-guided ESP or TAP block was given using 0.2% ropivacaine (0.2 ml/kg on either side). Postoperatively visual analogue scale (VAS) score and analgesic requirement of each patient was assessed at regular interval for 48 h by a blinded investigator. Statistical analysis was done using SPSS version 21. Student's -test and Chi-square test were used for demographic and other data.

RESULTS

ESP block provided prolonged analgesia compared to the TAP block, andthe mean time to first rescue analgesia was 43.53 h and 12.07 h, respectively ( < 0.001). The requirement for total analgesic was also significantly less in the ESP group compared to the TAP group ( < 0.001).

CONCLUSION

ESP block provided prolonged analgesia with a significant decrease in analgesic requirement compared to TAP block and can be used as a standard technique for post-cesarean analgesia.

摘要

背景与目的

竖脊肌平面(ESP)阻滞是一种在脊柱旁区域进行的筋膜间平面阻滞,可提供有效的内脏和躯体镇痛。腹横肌平面(TAP)阻滞也是一种筋膜间阻滞,可提供充分的躯体疼痛控制。我们进行了这项研究,以比较剖宫产术后48小时内ESP阻滞和TAP阻滞联合罗哌卡因的镇痛效果。

材料与方法

60例计划在脊髓麻醉下进行择期剖宫产的患者,随机分为ESP阻滞组(n = 30)或TAP阻滞组(n = 30)。手术完成后,使用0.2%罗哌卡因(每侧0.2 ml/kg)进行超声引导下的ESP或TAP阻滞。术后由一名盲法研究者定期评估每位患者的视觉模拟评分(VAS)和镇痛需求,持续48小时。使用SPSS 21版进行统计分析。采用学生t检验和卡方检验分析人口统计学和其他数据。

结果

与TAP阻滞相比,ESP阻滞提供了更长时间的镇痛,首次补救镇痛的平均时间分别为43.53小时和12.07小时(P < 0.001)。与TAP组相比,ESP组的总镇痛需求也显著减少(P < 0.001)。

结论

与TAP阻滞相比,ESP阻滞提供了更长时间的镇痛,且镇痛需求显著降低,可作为剖宫产术后镇痛的标准技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30a8/7480289/ae7159743d95/JOACP-36-201-g001.jpg

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