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小儿包皮环切术后骶尾部阻滞与骶棘肌阻滞的术后镇痛效果比较:一项双盲、随机对照试验。

Comparison of Caudal Block and Sacral Erector Spina Block for Postoperative Analgesia following Pediatric Circumcision: A Double-Blind, Randomized Controlled Trial.

机构信息

Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.

Department of Anesthesiology and Reanimation, Kanuni Sultan Suleiman Training and Research Hospital, Istanbul, Turkey.

出版信息

Urol Int. 2024;108(4):292-297. doi: 10.1159/000538323. Epub 2024 Mar 16.

Abstract

INTRODUCTION

Caudal block (CB) and erector spina plane block (ESPB) have been shown to provide effective postoperative analgesia following circumcision. Our aim was to compare the analgesic efficacy of sacral ESPB and CB, as well as the time to first analgesic requirement and postoperative complications.

METHODS

Patients aged 1-7 years in the ASA I-II group, who were scheduled for circumcision, were included in the study. Blocks were performed under general anesthesia before the operation. Postoperative pain was evaluated using the Face, Legs, Activity, Cry, and Consolability (FLACC) scores. Analgesic requirements in the first 24 h postsurgery, the time of first analgesia requirement, and postoperative complications were recorded.

RESULTS

A total number of 150 patients were included in the study. In the CB group, urinary retention was observed. No side effects were observed in the sacral ESPB group. The 4th and 6th h postoperative FLACC scores were lower in the ESP group. The number of analgesic consumption in the first 24 h postsurgery was significantly lower in the ESPB group (p < 0.001).

CONCLUSION

Based on our results, sacral ESPB performed with ultrasonography is a simple and safe regional anesthesia method that can be used to provide effective postoperative analgesia for circumcision.

摘要

引言

阴部神经阻滞(CB)和竖脊肌平面阻滞(ESPB)已被证明可有效缓解包皮环切术后的疼痛。我们的目的是比较骶部 ESPB 和 CB 的镇痛效果,以及首次需要镇痛的时间和术后并发症。

方法

本研究纳入了年龄在 1-7 岁、ASA I-II 级的拟行包皮环切术的患者。在全身麻醉下进行阻滞。术后采用面部、腿部、活动、哭泣和安慰(FLACC)评分评估疼痛。记录术后 24 小时内的镇痛需求、首次需要镇痛的时间和术后并发症。

结果

共有 150 例患者纳入本研究。在 CB 组中,观察到尿潴留。在骶部 ESPB 组中未观察到任何副作用。ESP 组术后第 4 小时和第 6 小时的 FLACC 评分较低。术后 24 小时内的镇痛药物消耗数量在 ESPB 组显著降低(p < 0.001)。

结论

根据我们的结果,超声引导下的骶部 ESPB 是一种简单、安全的区域麻醉方法,可有效用于包皮环切术后的镇痛。

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