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超声引导腹横筋膜平面阻滞与竖脊肌平面阻滞在椎管内麻醉下开放腹股沟疝修补术中的镇痛效果比较。

Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia.

机构信息

Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey.

Department of General Surgery, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey.

出版信息

Korean J Anesthesiol. 2024 Apr;77(2):255-264. doi: 10.4097/kja.23404. Epub 2024 Jan 8.


DOI:10.4097/kja.23404
PMID:38185619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10982532/
Abstract

BACKGROUND: Open inguinal hernia repair (OIHR) surgery is a common surgical procedure, and ultrasound guided interfascial plane blocks can also be included in current approaches to postoperative multimodal analgesia regimens. This study aimed to compare the postoperative analgesic efficacy of the erector spinae plane block (ESPB) and transversalis fascia plane block (TFPB) in patients undergoing OIHR. METHODS: This prospective, randomized, assessor-blinded comparative study was conducted in the postoperative recovery room and ward of a tertiary hospital. A total of 80 patients with American Society of Anesthesiologists physical status I-III were enrolled and allocated equally to either the ESPB or TFPB group. The patients received standard multimodal analgesia in addition to an ultrasound-guided ESPB or TFPB. During the first 24 h postoperatively, tramadol consumption was assessed and pain levels at rest and during movement were compared using numeric rating scale (NRS) scores at 1, 3, 6, 9, 12, 18, and 24 h postoperatively. RESULTS: The results showed no difference in NRS scores at any time point between the groups, except for NRS at rest in the third hour. However, tramadol consumption was lower in the TFPB group than in the ESPB group overall (88 ± 75.2 vs. 131 ± 93.7 mg, respectively; P = 0.027, mean difference: -43, 95% CI [-80.82, -5.18]). CONCLUSIONS: The TFPB leads to lower tramadol requirements in the first 24 h postoperatively than the ESPB in patients undergoing OIHR.

摘要

背景:开放式腹股沟疝修补术(OIHR)是一种常见的手术,超声引导的筋膜间平面阻滞也可以包含在当前的多模式术后镇痛方案中。本研究旨在比较 OIHR 术后竖脊肌平面阻滞(ESPB)和腹横筋膜平面阻滞(TFPB)的术后镇痛效果。

方法:这是一项在三级医院的术后恢复室和病房进行的前瞻性、随机、评估者盲法比较研究。共纳入 80 名美国麻醉医师协会身体状况 I-III 级的患者,并平均分为 ESPB 或 TFPB 组。患者在接受标准多模式镇痛的基础上,接受超声引导下的 ESPB 或 TFPB。术后 24 小时内,评估曲马多的消耗量,并在术后 1、3、6、9、12、18 和 24 小时使用数字评分量表(NRS)比较静息和运动时的疼痛水平。

结果:结果显示,两组在任何时间点的 NRS 评分均无差异,除了第 3 小时静息时的 NRS 评分。然而,总的来说,TFPB 组的曲马多消耗量低于 ESPB 组(88±75.2 与 131±93.7 mg,分别;P=0.027,平均差异:-43,95%CI[-80.82,-5.18])。

结论:在接受 OIHR 的患者中,TFPB 在术后 24 小时内导致的曲马多需求低于 ESPB。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/ae8337db584b/kja-23404f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/60a75bc14e5c/kja-23404f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/57802a52d402/kja-23404f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/ae8337db584b/kja-23404f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/60a75bc14e5c/kja-23404f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/57802a52d402/kja-23404f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f455/10982532/ae8337db584b/kja-23404f3.jpg

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本文引用的文献

[1]
Ultrasound-guided transversalis fascia plane block for postoperative analgesia: A systematic review and meta-analysis.

Indian J Anaesth. 2023-4

[2]
Ultrasound-guided transversalis fascia plane block versus lateral quadratus lumborum plane block for analgesia after inguinal herniotomy in children: a randomized controlled non-inferiority study.

BMC Anesthesiol. 2023-3-17

[3]
Efficacy of transversalis fascia plane block as a novel ındication for varicocelectomy surgery: prospective randomized controlled study.

BMC Anesthesiol. 2023-2-7

[4]
Posterior quadratus lumborum block versus posterior transversus abdominis plane block for unilateral inguinal hernia surgery.

Niger J Clin Pract. 2022-9

[5]
Core outcome set for peripheral regional anesthesia research: a systematic review and Delphi study.

Reg Anesth Pain Med. 2022-7-21

[6]
Quadrant and Dermatomal Analysis of Sensorial Block in Ultrasound- Guided Erector Spinae Plane Block.

Eurasian J Med. 2022-6

[7]
Ultrasound-guided erector spinae plane block for open inguinal hernia repair: a randomized controlled trial.

Braz J Anesthesiol. 2022

[8]
Ultrasound-guided transversalis fascia plane block transmuscular quadratus lumborum block for post-operative analgesia in inguinal hernia repair.

Korean J Pain. 2021-4-1

[9]
Lumbar erector spinae plane block: a miracle or self-persuasion?

Reg Anesth Pain Med. 2021-7

[10]
Ultrasound-guided fascial plane blocks of the chest wall: a state-of-the-art review.

Anaesthesia. 2021-1

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