单侧菱形肌和肋间下平面阻滞在腹腔镜胆囊切除术后镇痛中的应用:一项准实验研究。

Application of unilateral rhomboid intercostal and subserratus plane block for analgesia after laparoscopic cholecystectomy: a quasi-experimental study.

机构信息

Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Yildirim, Bursa, Turkey.

出版信息

Korean J Anesthesiol. 2022 Feb;75(1):79-85. doi: 10.4097/kja.21229. Epub 2021 Jul 20.

Abstract

BACKGROUND

Interfascial plane block can be used to treat postoperative pain after laparoscopic surgery. This study aimed to investigate the effect of ultrasound-guided unilateral rhomboid intercostal and subserratus plane (RISS) block after laparoscopic cholecystectomy on the amount of analgesic consumption.

METHODS

Fifty patients who underwent laparoscopic cholecystectomy were included in this quasi-experimental study. Patients fulfilling the inclusion criteria were analyzed in two groups: RISS group (RISS block with 20 ml of 0.25% bupivacaine + intravenous patient-controlled analgesia [IV-PCA] tramadol [n = 25]); and Control group (IV-PCA tramadol [n = 25]). The primary outcome was the total amount of tramadol used over 24 h. Secondary outcomes included side effects, additional analgesic use, and postoperative pain (at rest and during activity) at 2, 6, 12, and 24 h according to numerical rating scale (NRS) scores.

RESULTS

Postoperative tramadol consumption at 24 h was significantly lower in the RISS group than in the Control group (P < 0.001). Resting NRS scores at 2 h and 6 h were significantly lower in the RISS group. NRS scores during movement in the RISS group were significantly lower at 2, 6, and 12 h postoperatively. There was no statistically significant difference in the rate of side effects and additional analgesic use between the groups (P > 0.05).

CONCLUSIONS

Unilateral RISS block was an effective method for pain management after laparoscopic cholecystectomy and can be used as a part of multimodal analgesia.

摘要

背景

筋膜平面阻滞可用于治疗腹腔镜手术后的术后疼痛。本研究旨在探讨腹腔镜胆囊切除术后超声引导下单侧菱形肋间和肋下平面(RISS)阻滞对镇痛药物消耗的影响。

方法

本准实验研究纳入了 50 例接受腹腔镜胆囊切除术的患者。符合纳入标准的患者分为两组:RISS 组(20ml0.25%布比卡因+静脉自控镇痛[IV-PCA]曲马多[n=25]);和对照组(IV-PCA 曲马多[n=25])。主要结局是 24 小时内曲马多的总用量。次要结局包括 2、6、12 和 24 小时的不良反应、额外镇痛药物使用和术后疼痛(静息和活动时),采用数字评分量表(NRS)评分。

结果

RISS 组术后 24 小时曲马多消耗量明显低于对照组(P<0.001)。RISS 组在 2 小时和 6 小时静息 NRS 评分明显较低。RISS 组在运动时 NRS 评分在术后 2、6 和 12 小时明显较低。两组不良反应和额外镇痛药物使用的发生率无统计学差异(P>0.05)。

结论

单侧 RISS 阻滞是腹腔镜胆囊切除术后疼痛管理的有效方法,可作为多模式镇痛的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a7e/8831438/c2348f7d7687/kja-21229f1.jpg

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