Department of Urology in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.
Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.
Int J Environ Res Public Health. 2021 Mar 31;18(7):3625. doi: 10.3390/ijerph18073625.
Erector spinae plane block was recently introduced as an alternative to postoperative analgesia in surgical procedures including thoracoscopies and mastectomies. There are no clinical trials regarding erector spinae plane block in percutaneous nephrolithotomy. The aim of our study was to test the efficacy and safety of erector spinae plane block after percutaneous nephrolithotomy. We analyzed 68 patients, 34 of whom received erector spinae plane block. The average visual analogue scale score 24 h postoperatively was the primary endpoint. The secondary endpoints were nalbuphine consumption and the need for rescue analgesia. Safety measures included the mean arterial pressure, Ramsey scale score, and rate of nausea and vomiting. The visual analogue scale, blood pressure, and Ramsey scale were assessed simultaneously at 1, 2, 4, 6, 12, and 24 h postoperatively. The average visual analogue scale was 2.9 and 3 ( = 0.65) in groups 1 (experimental) and 2 (control), respectively. The visual analogue scale after 1 h postoperatively was significantly lower in the erector spinae plane block group (2.3 vs. 3.3; = 0.01). The average nalbuphine consumption was the same in both groups (46 mL vs. 47.2 mL, = 0.69). The need for rescue analgesia was insignificantly different in both groups (group 1, 29.4; group 2, 26.4%; = 1). The mean arterial pressure was similar in both groups postoperatively (91.8 vs. 92.5 mmHg; = 0.63). The rate of nausea and vomiting was insignificantly different between the groups (group 1, 17.6%; group 2, 14.7%; = 1). The median Ramsey scale in all the measurements was two. Erector spinae plane block is an effective pain treatment after percutaneous nephrolithotomy but only for a very short postoperative period.
竖脊肌平面阻滞最近被引入作为胸腹腔镜检查和乳房切除术等手术术后镇痛的替代方法。目前尚无关于经皮肾镜碎石术的竖脊肌平面阻滞的临床试验。我们的研究目的是测试经皮肾镜碎石术后竖脊肌平面阻滞的疗效和安全性。我们分析了 68 例患者,其中 34 例接受了竖脊肌平面阻滞。术后 24 小时平均视觉模拟评分是主要终点。次要终点是纳布啡的消耗和需要急救镇痛。安全措施包括平均动脉压、拉姆齐评分和恶心呕吐发生率。术后 1、2、4、6、12 和 24 小时同时评估视觉模拟评分、血压和拉姆齐评分。1 组(实验组)和 2 组(对照组)的平均视觉模拟评分分别为 2.9 和 3(=0.65)。术后 1 小时竖脊肌平面阻滞组的视觉模拟评分明显较低(2.3 与 3.3;=0.01)。两组纳布啡的平均消耗量相同(46 毫升与 47.2 毫升;=0.69)。两组急救镇痛的需求无显著差异(1 组 29.4%;2 组 26.4%;=1)。术后两组平均动脉压相似(91.8 与 92.5mmHg;=0.63)。两组恶心呕吐发生率无显著差异(1 组 17.6%;2 组 14.7%;=1)。所有测量的中位数拉姆齐评分均为 2 分。竖脊肌平面阻滞是经皮肾镜碎石术后有效的止痛治疗方法,但仅在术后非常短的时间内有效。