Department of Anesthesiology and Reanimation, Koç University Hospital, Istanbul, Türkiye -
Department of Anesthesiology, Acıbadem Ataşehir Hospital, İstanbul, Türkiye.
Minerva Anestesiol. 2024 Mar;90(3):154-161. doi: 10.23736/S0375-9393.23.17706-6. Epub 2024 Feb 2.
The erector spinae plane block is a relatively new regional anesthesia technique that is expected to provide some benefits for postoperative analgesia. This study investigated the effects of erector spinae plane block on postoperative opioid consumption in kidney donors undergoing hand-assisted laparoscopic donor nephrectomy for renal transplantation.
Fifty-two donors scheduled for elective hand-assisted laparoscopic donor nephrectomy were randomly divided into the block (25 donors) and control (27 donors) groups. Donors in the block group received 30 mL of 0.25% bupivacaine under ultrasound guidance, whereas the control group received no block treatment. The primary outcome measure was the amount of fentanyl administered via patient-controlled analgesia at 24 h. Secondary outcomes included the duration of stay, opioid consumption in the post-anesthesia care unit, and pain scores during the recording hours.
No significant differences were observed between the groups regarding total opioid consumption converted to intravenous morphine equivalent administered via patient-controlled analgesia (33.3±21.4 mg vs. 37.5±18.5 mg; P=0.27) and in the postanesthesia care unit (1.5±0.9 mg vs. 1.4±0.8 mg; P=0.55). The duration of stay in the postanesthesia care unit (86.3±32.6 min vs. 85.7±33.6 min; P=0.87) was similar between the groups. There was no significant difference between the groups in the postoperative donor-reported NRS pain scores (P>0.05 for all the time points).
Preoperative erector spinae plane block is not an effective strategy for reducing postoperative pain or opioid consumption in patients undergoing hand-assisted laparoscopic donor nephrectomy. Different block combinations are needed for optimal pain management in hand-assisted laparoscopic donor nephrectomy.
竖脊肌平面阻滞是一种相对较新的区域麻醉技术，有望为术后镇痛提供一些益处。本研究旨在探讨竖脊肌平面阻滞对接受手助腹腔镜供肾切取术的肾移植供者术后阿片类药物消耗的影响。
52 例择期行手助腹腔镜供肾切取术的供者随机分为阻滞组（25 例）和对照组（27 例）。阻滞组在超声引导下接受 30ml0.25%布比卡因，对照组则不接受阻滞治疗。主要观察指标为术后 24 小时患者自控镇痛（PCA）给予的芬太尼用量。次要观察指标包括术后住院时间、麻醉后监护室（PACU）的阿片类药物用量和记录时间内的疼痛评分。
两组患者 PCA 给予的静脉吗啡等效物（33.3±21.4mg 比 37.5±18.5mg；P=0.27）和 PACU 给予的阿片类药物（1.5±0.9mg 比 1.4±0.8mg；P=0.55）总量无显著差异。两组患者 PACU 停留时间（86.3±32.6min 比 85.7±33.6min；P=0.87）相似。两组患者术后供者报告的 NRS 疼痛评分（所有时间点 P>0.05）均无显著差异。
术前竖脊肌平面阻滞不是一种有效策略，不能减少手助腹腔镜供肾切取术患者的术后疼痛或阿片类药物消耗。需要不同的阻滞组合来优化手助腹腔镜供肾切取术的疼痛管理。
