比较竖脊肌平面阻滞与椎旁阻滞用于胸腔镜手术的效果：一项随机对照试验的荟萃分析。

Comparison of erector spinae plane block with paravertebral block for thoracoscopic surgery: a meta-analysis of randomized controlled trials.

机构信息

Department of Cardiothoracic Surgery, Fenghua District People's Hospital of Ningbo, Zhejiang, China.

出版信息

J Cardiothorac Surg. 2023 Oct 27;18(1):300. doi: 10.1186/s13019-023-02343-w.

INTRODUCTION

The efficacy of erector spinae plane block versus paravertebral block for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of erector spinae plane block versus paravertebral block on thoracoscopic surgery.

METHODS

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2022 for randomized controlled trials (RCTs) assessing the effect of erector spinae plane block versus paravertebral block on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.

RESULTS

Seven RCTs are included in the meta-analysis. Overall, compared with erector spinae plane block for thoracoscopic surgery, paravertebral block results in significantly reduced pain scores at 12 h (SMD = 1.12; 95% CI 0.42 to 1.81; P = 0.002) and postoperative anesthesia consumption (SMD = 1.27; 95% CI 0.30 to 2.23; P = 0.01), but these two groups have similar pain scores at 1-2 h (SMD = 1.01; 95% CI - 0.13 to 2.15; P 0.08) and 4-6 h (SMD = 0.33; 95% CI - 0.16 to 0.81; P = 0.19), as well as incidence of nausea and vomiting (OR 0.93; 95% CI 0.38 to 2.29; P = 0.88).

CONCLUSIONS

Paravertebral block may be better for the pain relief after thoracoscopic surgery than erector spinae plane block.

简介

竖脊肌平面阻滞与椎旁阻滞在胸腔镜手术中的疗效仍存在争议。我们进行了系统回顾和荟萃分析，以探讨竖脊肌平面阻滞与椎旁阻滞对胸腔镜手术的影响。

方法

我们通过检索 PubMed、EMbase、Web of Science、EBSCO 和 Cochrane 图书馆数据库，检索了截至 2022 年 3 月评估竖脊肌平面阻滞与椎旁阻滞对胸腔镜手术影响的随机对照试验（RCT）。本荟萃分析采用随机效应模型进行。

结果

共有 7 项 RCT 纳入荟萃分析。总体而言，与胸腔镜手术中的竖脊肌平面阻滞相比，椎旁阻滞在术后 12 小时（SMD=1.12；95%CI 0.42 至 1.81；P=0.002）和术后麻醉消耗（SMD=1.27；95%CI 0.30 至 2.23；P=0.01）方面疼痛评分显著降低，但两组在术后 1-2 小时（SMD=1.01；95%CI -0.13 至 2.15；P=0.08）和 4-6 小时（SMD=0.33；95%CI -0.16 至 0.81；P=0.19）的疼痛评分以及恶心和呕吐的发生率（OR 0.93；95%CI 0.38 至 2.29；P=0.88）方面相似。