竖脊肌平面阻滞可改善椎板切除术和椎间盘切除术术后的恢复：一项回顾性队列研究。
Erector spinae plane block improves postoperative recovery after laminectomy and discectomy surgery: a retrospective cohort study.
机构信息
Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
出版信息
BMC Anesthesiol. 2023 Sep 12;23(1):308. doi: 10.1186/s12871-023-02271-1.
BACKGROUND
There is still room for improvement of pain management after spinal surgery. The goal of this study was to evaluate adding the erector spinae block to the standard analgesia regimen. Our hypothesis was that the erector spinae plane block will decrease length of hospital stay, reduce opioid need and improve numeric rating scale pain scores.
METHODS
This was a single center retrospective cohort study. We included 418 patients undergoing laminectomy or discectomy from January 2019 until December 2021. The erector spinae plane block was introduced in 2016 by Forero and colleagues and added to our clinical practice in October 2020. Patients who did not receive an erector spinae plane block prior to its implementation in October 2020 were used as control group. The primary outcome measure was functional recovery, measured by length of hospital stay. Secondary outcome measures were perioperative opioid consumption, need for patient-controlled analgesia and numeric rating scale pain scores. Postoperative data collection time points were: at the PACU and after 3, 6, 12 and 24 h postoperatively.
RESULTS
There was a significant shorter length of hospital stay in patients undergoing single level laminectomy (with erector spinae plane block 29 h (IQR 27-51), without block 53 h (IQR 51-55), p < .001), multiple level laminectomy (with erector spinae plane block 49 h (IQR 31-54), without block 54 h (IQR 52-75), p < .001) and discectomy (with erector spinae plane block 27 h (IQR 25-30), without block 29 h (IQR 28-49), p = .04).
CONCLUSIONS
Erector spinae plane block reduces length of stay after laminectomy surgery.
背景
脊柱手术后的疼痛管理仍有改进空间。本研究的目的是评估在标准镇痛方案中加入竖脊肌平面阻滞的效果。我们的假设是竖脊肌平面阻滞将减少住院时间、减少阿片类药物的需求并改善数字评分量表疼痛评分。
方法
这是一项单中心回顾性队列研究。我们纳入了 2019 年 1 月至 2021 年 12 月期间行椎板切除术或椎间盘切除术的 418 例患者。竖脊肌平面阻滞由 Forero 等人于 2016 年引入，并于 2020 年 10 月纳入我们的临床实践。将 2020 年 10 月实施该阻滞前未接受该阻滞的患者作为对照组。主要观察指标为功能恢复，以住院时间衡量。次要观察指标为围手术期阿片类药物消耗、患者自控镇痛需求和数字评分量表疼痛评分。术后数据采集时间点为：PACU 以及术后 3、6、12 和 24 小时。
结果
单节段椎板切除术患者的住院时间明显缩短（有竖脊肌平面阻滞组 29 小时（IQR 27-51），无阻滞组 53 小时（IQR 51-55），p<0.001）、多节段椎板切除术（有竖脊肌平面阻滞组 49 小时（IQR 31-54），无阻滞组 54 小时（IQR 52-75），p<0.001）和椎间盘切除术（有竖脊肌平面阻滞组 27 小时（IQR 25-30），无阻滞组 29 小时（IQR 28-49），p=0.04）。
结论
竖脊肌平面阻滞可减少椎板切除术后的住院时间。
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