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竖脊肌平面阻滞在减重手术中恢复质量的疗效:一项随机对照试验。

Efficacy of the Erector Spinae Plane Block for Quality of Recovery in Bariatric Surgery: a Randomized Controlled Trial.

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Karamanoğlu Mehmetbey University, Yunus Emre Campus, 70200, Karaman, Turkey.

Department of General Surgery, Faculty of Medicine, Karamanoğlu Mehmetbey University, Yunus Emre Campus, 70200, Karaman, Turkey.

出版信息

Obes Surg. 2023 Sep;33(9):2640-2651. doi: 10.1007/s11695-023-06748-3. Epub 2023 Jul 24.

Abstract

BACKGROUND

Postoperative pain management after bariatric surgery is difficult due to different physiological properties and high sensitivity toward opioids in patients with obesity. It has been reported that erector spinae plane block (ESPB) contributes to postoperative analgesia when applied together with multimodal analgesia.

METHODS

Eighty patients were randomized either bilateral ESPB (group E) each side or no block (group C). Our primary aim was to evaluate the effects of ESPB on the quality of recovery 24 h postoperatively in bariatric surgery by using 40-item Quality of Recovery-40 (QoR-40) questionnaire. Postoperative pain assessed using a numerical rating scale (NRS), time of additional analgesic requirement, analgesic consumption, side effects, sedation, mobilization time, and postoperative complications were evaluated as secondary outcomes.

RESULTS

Postoperative mean QoR-40 scores were found to be higher in group E (175.02 ± 11.25) than in group C (167.78 ± 18.59) at the postoperative 24th hour (P < 0.05). Pain scores at rest and during movement were higher in group C than in group E. At the postoperative 24th hour, NRS mean SD scores at rest for group C and group E were 3.25 ± 1.32 and 2.40 ± 0.96, respectively. NRS mean SD scores during movement for groups C and E were 3.88 ± 1.49 and 3.12 ± 1.30, respectively. The total amount of tramadol consumed in the first 24 h in group C and group E were mean SD: 86.40 ± 69.60 and 40.00 ± 46.96, respectively; P < 0.05.

CONCLUSIONS

ESPB improved postoperative quality of recovery, reduced NRS scores, and total analgesic consumption in patients with obesity undergoing bariatric surgery.

CLINICAL TRIAL REGISTRATION

NCT05020379.

摘要

背景

肥胖患者由于生理特性不同且对阿片类药物高度敏感,因此术后疼痛管理较为困难。有报道称,竖脊肌平面阻滞(ESPB)与多模式镇痛联合应用有助于术后镇痛。

方法

80 名患者随机分为双侧 ESPB 组(E 组,每侧各 1 次)或无阻滞组(C 组)。我们的主要目的是通过使用 40 项恢复质量问卷(QoR-40)评估 ESPB 对肥胖患者减重手术后 24 小时恢复质量的影响。术后疼痛采用数字评分量表(NRS)评估,评估指标包括额外镇痛需求时间、镇痛药物消耗、不良反应、镇静、活动时间和术后并发症。

结果

术后 24 小时,E 组 QoR-40 评分(175.02±11.25)高于 C 组(167.78±18.59)(P<0.05)。E 组静息和运动时的疼痛评分均低于 C 组。术后 24 小时,C 组和 E 组静息时的 NRS 平均标准差评分分别为 3.25±1.32 和 2.40±0.96,运动时的 NRS 平均标准差评分分别为 3.88±1.49 和 3.12±1.30。C 组和 E 组在术后 24 小时内消耗的曲马多总量的平均值分别为 86.40±69.60 和 40.00±46.96(P<0.05)。

结论

ESPB 可改善肥胖患者减重手术后的恢复质量,降低 NRS 评分和总镇痛药物消耗。

临床试验注册号

NCT05020379。

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