Department of Anesthesiology, Istanbul Medipol University, School of Medicine, Istanbul, Turkey.
Department of Algology, Manisa State Hospital, Manisa, Turkey.
Pain Med. 2021 Apr 20;22(4):776-783. doi: 10.1093/pm/pnaa359.
Moderate to severe pain may occur following arthroscopic shoulder surgery. An erector spinae plane block (ESPB) may be used for painful conditions of the shoulder. The primary hypothesis of this trial is that ultrasound-guided ESPB would provide effective analgesia by reducing opioid consumption. The secondary hypothesis is that ESPB would result in low pain scores and reduce the use of rescue analgesia.
Randomized prospective double-blind study.
Academic university hospital.
Sixty patients aged between 18 and 65 years designated as American Society of Anesthesiologists (ASA) class I or II who underwent unilateral arthroscopic shoulder surgery under general anesthesia were included in the study.
Patients were equally divided into two groups-either the ESPB group (n=30) or the sham block group (n=30). ESPB was performed with 30 mL 0.25% bupivacaine at the T2 level in the ESPB group and sham block with 30 mL saline at the T2 level in the sham block group. Twenty minutes before the end of the operation, 100 mg tramadol was administered intravenously to the patients. Intravenous ibuprofen 400 mg 3 × 1 was ordered for the patients during the postoperative period. A patient control analgesia device including a dose of 10 µg/mL fentanyl was connected to the patients.
There were no statistical differences between groups in terms of demographical data. Postoperative fentanyl consumption was significantly lower in the ESPB group than in the sham block group (96.66 µg ±105.57 µg and 230 µg ±247.17 µg, respectively) (P=0.009). The need for rescue analgesia was significantly lower in the ESPB group than in the sham block group (26.66 mg ±35.43 mg and 48.5 mg ±35.45 mg, respectively) (P=0.020). Overall, the visual analog scale scores were significantly lower in the ESPB group than in the sham block group.
ESPB may provide effective analgesia treatment following arthroscopic shoulder surgery.
关节镜肩关节手术后可能会出现中度至重度疼痛。竖脊肌平面阻滞（ESPB）可用于治疗肩部疼痛性疾病。本试验的主要假设是超声引导下的 ESPB 通过减少阿片类药物的使用来提供有效的镇痛。次要假设是 ESPB 将产生较低的疼痛评分并减少对抢救性镇痛的需求。
随机前瞻性双盲研究。
学术大学医院。
纳入研究的患者为年龄在 18 岁至 65 岁之间、ASA 分级 I 或 II 级的 60 名接受全身麻醉下单侧关节镜肩关节手术的患者。
患者分为两组，即 ESPB 组（n=30）或假阻滞组（n=30）。ESPB 组在 T2 水平注射 30ml 0.25%布比卡因，假阻滞组在 T2 水平注射 30ml 生理盐水。在手术结束前 20 分钟，静脉注射 100mg 曲马多给患者。术后期间，给患者开静脉注射布洛芬 400mg 3×1 次。患者连接了包括 10μg/ml 芬太尼剂量的患者自控镇痛装置。
两组患者的人口统计学数据无统计学差异。ESPB 组术后芬太尼消耗量明显低于假阻滞组（分别为 96.66μg±105.57μg 和 230μg±247.17μg）（P=0.009）。ESPB 组需要抢救性镇痛的人数明显少于假阻滞组（分别为 26.66mg±35.43mg 和 48.5mg±35.45mg）（P=0.020）。总体而言，ESPB 组的视觉模拟评分明显低于假阻滞组。
ESPB 可能为关节镜肩关节手术后提供有效的镇痛治疗。
