Viderman Dmitriy, Aubakirova Mina, Abdildin Yerkin G
Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan.
Department of Mechanical and Aerospace Engineering, School of Engineering and Digital Sciences, Nazarbayev University, Nur-Sultan, Kazakhstan.
Front Med (Lausanne). 2022 Feb 23;9:812531. doi: 10.3389/fmed.2022.812531. eCollection 2022.
Abdominal surgery is one of the most definitive and mainstay treatment options for abdominal pathologies in clinical practice. Acute postoperative pain is a major challenge in the postoperative period. Although opioids are commonly used for analgesia after major abdominal surgeries, they can lead to side effects, such as nausea and vomiting, constipation, pruritus, and life-threatening respiratory depression. Regional anesthetic techniques are commonly used to prevent or minimize these side effects. The objective of this meta-analysis is to assess the effectiveness of erector spinae plane block (ESPB) and standard medical (no block) pain management after major abdominal surgeries.
We searched for articles reporting the results of randomized controlled trials on ESPB and no block in pain control published before May 2021.
The systematic search initially yielded 56 publications, 49 articles were excluded, and seven randomized clinical trials were included and analyzed. We extracted the data on postoperative opioid consumption, the efficacy of pain relief, time to the first opioid demand, and the rate of postoperative complications in the ESPB group and no block group.
Opioid requirement and time to first analgesic request were significantly reduced in the ultrasound-guided ESPB group, but pain scores, nausea, and vomiting did not differ significantly after pooling the results of the block and no block studies. There were no reports on serious complications related to ESPB.
腹部手术是临床实践中治疗腹部疾病最具决定性的主要治疗选择之一。术后急性疼痛是术后阶段的一项重大挑战。尽管阿片类药物常用于大型腹部手术后的镇痛，但它们会导致副作用，如恶心、呕吐、便秘、瘙痒以及危及生命的呼吸抑制。区域麻醉技术常用于预防或尽量减少这些副作用。本荟萃分析的目的是评估竖脊肌平面阻滞（ESPB）与大型腹部手术后标准药物（无阻滞）疼痛管理的有效性。
我们检索了2021年5月之前发表的关于ESPB和无阻滞在疼痛控制方面的随机对照试验结果的文章。
系统检索最初得到56篇出版物，排除49篇文章，纳入并分析了7项随机临床试验。我们提取了ESPB组和无阻滞组术后阿片类药物消耗量、疼痛缓解效果、首次需要阿片类药物的时间以及术后并发症发生率的数据。
超声引导下的ESPB组阿片类药物需求量和首次镇痛需求时间显著减少，但汇总阻滞和无阻滞研究结果后，疼痛评分、恶心和呕吐情况无显著差异。没有关于ESPB相关严重并发症的报告。
