Selvi Onur, Tulgar Serkan, Serifsoy Talat Ercan, Lance Robert, Thomas David Terence, Gürkan Yavuz
Department of Anaesthesia, Anesthesiology and Reanimation, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK.
Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey.
Eurasian J Med. 2022 Jun;54(2):121-126. doi: 10.5152/eurasianjmed.2022.21151.
As a novel procedure now gaining popularity, erector spinae plane block has been the subject of many studies. However, dermatomal coverage of the sensory block caused by erector spinae plane block has been rarely studied. The goal of this study is to evaluate the sensory block resulting from erector spinae plane block applied at the T9 vertebral level.
This observational, prospective, blinded study was conducted on 50 adult patients undergoing laparoscopic abdominal surgery. All patients underwent bilateral erector spinae plane block at the T9 level after completion of the surgery while under general anesthesia. In order to further evaluate the sensory blockade, we divided the hemiabdomen-hemithorax region into 4 quadrants: dorsal-medial, dorsal- laterel, ventral-lateral, and ventral-medial. The sensorial evaluation was performed using the pinprick test, 2 hours following the application of erector spinae plane block.
A total of 28 female and 22 male patients were examined in this study. Complete failure of the block was recorded in 7 patients, with no thoracic/lumbar segmental or quadrant involvement. Successful sensory block was achieved in 67% of the dorsolateral quadrants, 58% of the dorsomedial quadrants, 69% of the ventrolateral quadrants, and 55% of the ventromedial quadrants.
Cutaneous sensory block of erector spinae plane block at T9 vertebral level revealed variable results and low failure rates. Administration of erector spinae plane block for postoperative analgesia in thoracoab- dominal surgeries requires further randomized controlled trials to confirm its effectiveness and convenience.
竖脊肌平面阻滞作为一种新兴且日益普及的操作，已成为众多研究的主题。然而，竖脊肌平面阻滞所致感觉阻滞的皮节覆盖范围鲜有研究。本研究的目的是评估在T9椎体水平实施竖脊肌平面阻滞后产生的感觉阻滞情况。
本观察性、前瞻性、盲法研究针对50例接受腹腔镜腹部手术的成年患者开展。所有患者在全身麻醉下完成手术后，于T9水平接受双侧竖脊肌平面阻滞。为进一步评估感觉阻滞情况，我们将半腹半胸区域分为4个象限：背内侧、背外侧、腹外侧和腹内侧。在实施竖脊肌平面阻滞后2小时，采用针刺试验进行感觉评估。
本研究共检查了28例女性和22例男性患者。7例患者阻滞完全失败，未累及胸/腰节段或象限。背外侧象限感觉阻滞成功率为67%，背内侧象限为58%，腹外侧象限为69%，腹内侧象限为55%。
T9椎体水平竖脊肌平面阻滞的皮肤感觉阻滞结果各异且失败率较低。在胸腹部手术中应用竖脊肌平面阻滞进行术后镇痛，需要进一步的随机对照试验来证实其有效性和便利性。
