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超声引导竖脊肌平面阻滞用于中国腹腔镜胆囊切除术患者术后镇痛的双盲随机对照试验。

Ultrasound-guided erector spinae plane block for postoperative analgesia in Chinese patients undergoing laparoscopic cholecystectomy: a double-blind randomized controlled trial.

机构信息

Department of Anesthesiology, People's Hospital of Leshan, Leshan, 614000, People's Republic of China.

Department of Hepatopancreatobiliary Surgery, People's Hospital of Leshan, Leshan, 614000, People's Republic of China.

出版信息

Langenbecks Arch Surg. 2023 Feb 28;408(1):111. doi: 10.1007/s00423-023-02834-3.

Abstract

PURPOSE

Pain management after laparoscopic cholecystectomy (LC) is a main concern for Chinese clinicians. This study aims to explore the effect of erector spinae plane block (ESPB) on the postoperative analgesia of patients undergoing LC in China.

METHODS

In this randomized controlled trial (RCT), 220 patients were randomized into the ESPB group and control group. Patients in the ESPB group received a bilateral ESPB, and patients in the control group were injected saline. Lornoxicam (0.08 mg/mL, 100 mL) was used as routine analgesia for both groups after the surgery. Visual analog scale (VAS) score at rest state at 12 h postoperative was the primary outcome and divided into no pain, mild pain, moderate pain, and severe pain.

RESULTS

Finally, 197 patients were included for analysis. At postoperative 12 h, ESPB group observed less patients with moderate pain (0% vs. 8.91%) and severe pain (0% vs. 0.99%) than the control group (P < 0.001). Moreover, ESPB group found less dose of additional sufentanil (5.55 ± 1.37 μg vs. 10.67 ± 5.05 μg), less requirement for rescue analgesia (13.54% vs. 31.68%), earlier first time to leave bed (10 h vs. 18 h), and earlier first exhaust time (17.5 h vs. 25 h), less adverse reactions (5.21% vs. 17.82%), and higher satisfaction degree (78.13% vs. 31.68%) (all P < 0.05).

CONCLUSIONS

ESPB was followed by better postoperative analgesia and less opioid consumption.

摘要

目的

腹腔镜胆囊切除术(LC)后疼痛管理是中国临床医生关注的主要问题。本研究旨在探讨竖脊肌平面阻滞(ESPB)对中国行 LC 患者术后镇痛的效果。

方法

这是一项随机对照试验(RCT),共纳入 220 例患者,随机分为 ESPB 组和对照组。ESPB 组接受双侧 ESPB,对照组给予生理盐水注射。两组术后均采用罗痛定(0.08mg/mL,100mL)作为常规镇痛。术后 12 小时静息状态下的视觉模拟评分(VAS)为主要结局,并分为无痛、轻度疼痛、中度疼痛和重度疼痛。

结果

最终有 197 例患者纳入分析。术后 12 小时,ESPB 组中中度疼痛(0%比 8.91%)和重度疼痛(0%比 0.99%)患者明显少于对照组(P<0.001)。此外,ESPB 组需要的额外舒芬太尼剂量更少(5.55±1.37μg比 10.67±5.05μg),需要补救镇痛的比例更少(13.54%比 31.68%),首次下床时间更早(10 小时比 18 小时),首次排气时间更早(17.5 小时比 25 小时),不良反应发生率更低(5.21%比 17.82%),满意度更高(78.13%比 31.68%)(均 P<0.05)。

结论

ESPB 可提供更好的术后镇痛效果,并减少阿片类药物的消耗。

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