Department of Orthopaedic Surgery, Mater Private Hospital, Dublin, Ireland.
Department of Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
Anaesthesia. 2021 Nov;76(11):1499-1503. doi: 10.1111/anae.15488. Epub 2021 Apr 20.
Major spinal surgery causes significant postoperative pain. We tested the efficacy and safety of bilateral erector spinae block on quality of recovery and pain after thoracolumbar decompression. We randomly allocated 60 adults to standard care or erector spinae block. Erector spinae block improved the mean (SD) quality of recovery-15 score at 24 postoperative hours, from 119 (20) to 132 (14), an increase (95%CI) of 13 (4-22), p = 0.0044. Median (IQR [range]) comprehensive complication index was 1 (0-3 [0-5]) in the control group vs. 1 (0-1 [0-4]) after block, p = 0.4. Erector spinae block reduced mean (SD) area under the curve pain during the first 24 postoperative hours: at rest, from 78 (49) to 50 (39), p = 0.018; and on sitting, from 125 (51) to 91 (50), p = 0.009. The cumulative mean (SD) oxycodone consumption to 24 h was 27 (18) mg in the control group and 19 (26) mg after block, p = 0.20. In conclusion, erector spinae block improved recovery and reduced pain for 24 h after thoracolumbar decompression surgery.
主要脊柱手术后会引起明显的术后疼痛。我们测试了双侧竖脊肌阻滞对胸腰椎减压术后恢复质量和疼痛的疗效和安全性。我们将 60 名成年人随机分配至标准治疗组或竖脊肌阻滞组。竖脊肌阻滞可改善术后 24 小时时恢复质量-15 评分的均值（SD），从 119（20）增加至 132（14），增加了 13（4-22），p=0.0044。对照组的综合并发症指数中位数（IQR [范围]）为 1（0-3 [0-5]），而阻滞组为 1（0-1 [0-4]），p=0.4。竖脊肌阻滞可降低术后 24 小时内静息时和坐位时的疼痛曲线下面积的均值（SD）：静息时，从 78（49）降至 50（39），p=0.018；坐位时，从 125（51）降至 91（50），p=0.009。对照组术后 24 小时内的累积平均（SD）羟考酮消耗量为 27（18）mg，而阻滞组为 19（26）mg，p=0.20。总之，竖脊肌阻滞可改善胸腰椎减压术后 24 小时的恢复并减轻疼痛。
