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漏斗胸畸形患儿手术中冷冻镇痛前竖脊肌平面阻滞的益处。

Benefits of the Erector Spinae Plane Block before Cryoanalgesia in Children Undergoing Surgery for Funnel Chest Deformity.

作者信息

Zacha Sławomir, Jarosz Konrad, Kokot Karolina, Biłas Jarosław, Skonieczna-Żydecka Karolina, Gerus Sylwester, Kojder Klaudyna, Biernawska Jowita

机构信息

Department of Paediatric Orthopaedics and Musculoskeletal Oncology, Pomeranian Medical University, 71-252 Szczecin, Poland.

Department of Clinical Nursing, Pomeranian Medical University, 70-204 Szczecin, Poland.

出版信息

J Pers Med. 2023 Dec 9;13(12):1696. doi: 10.3390/jpm13121696.

Abstract

Thoracic surgery causes significant pain despite standard multimodal analgesia. Intraoperative cryoanalgesia may be a solution. The onset of the clinical effect of cryoanalgesia can take 12-36 h. The addition of a regional anaesthesia before the cryoanalgesia procedure can enable analgesic protection for the patient during this period. The main aim of the study was to evaluate the benefits of the erector spinae plane (ESP) block prior to Nuss surgery. The 'control' group consisted of 10 teenagers who underwent cryoablation together with intravenous multimodal analgesia according to the standard protocol. The 'intervention' group included 26 teenage patients who additionally received an erector spinae plane block before operation. Pain relief ( = 0.015), opioid use ( = 0.009), independent physical activity and rehabilitation ( = 0.020) were faster in the intervention group. No features of local anaesthetic drug toxicity or complications of the ESP block were observed. The bilateral ESP block together with intraoperative intercostal nerve cryoablation performed prior to Nuss correction of funnel chest were more effective in terms of pain control.

摘要

尽管采用了标准的多模式镇痛方法,胸外科手术仍会引起显著疼痛。术中冷冻镇痛可能是一种解决办法。冷冻镇痛临床效果的起效时间可能为12 - 36小时。在冷冻镇痛程序之前加用区域麻醉可以在此期间为患者提供镇痛保护。本研究的主要目的是评估在努氏手术前竖脊肌平面(ESP)阻滞的益处。“对照组”由10名青少年组成,他们根据标准方案接受了冷冻消融术并联合静脉多模式镇痛。“干预组”包括26名青少年患者,他们在手术前额外接受了竖脊肌平面阻滞。干预组的疼痛缓解(P = 0.015)、阿片类药物使用(P = 0.009)、独立身体活动和康复(P = 0.020)更快。未观察到局部麻醉药毒性特征或ESP阻滞的并发症。在漏斗胸努氏矫正术前进行双侧ESP阻滞并联合术中肋间神经冷冻消融在疼痛控制方面更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4570/10744559/9ccd4e03b3f3/jpm-13-01696-g001.jpg

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