Yılmaz Elvan Tekir, Gülmez Duygu Demiriz, Apan Alparslan, Keles Bilge Olgun, Coşkun Mücahit, Döger Cihan, Kesicioglu Tugrul, Serim Vedat Ataman, Uygur Furkan Ali, Sengul Ilker
Giresun University, Faculty of Medicine, Department of Anesthesiology and Reanimation - Giresun, Turkey.
Başakşehir Çam and Sakura City Hospital - İstanbul, Turkey.
Rev Assoc Med Bras (1992). 2024 Apr 22;70(3):e20231457. doi: 10.1590/1806-9282.20231457. eCollection 2024.
OBJECTIVE: Erector spinae plane block is an updated method than paravertebral block, possessing a lower risk of complications. This study aimed to compare erector spinae plane and paravertebral blocks to safely reach the most efficacious analgesia procedure in laparoscopic cholecystectomy cases. METHODS: The study included 90 cases, aged 18-70 years, classified as American Society of Anesthesiologists I-II, who underwent an laparoscopic cholecystectomy procedure. They were randomly separated into three groups, namely, Control, erector spinae plane, and paravertebral block. No block procedure was applied to Control, and a patient-controlled analgesia device was prepared containing tramadol at a 10 mg bolus dose and a 10-min locked period. The pain scores were recorded with a visual analog scale for 24 h postoperatively. RESULTS: The visual analog scale values at 1, 5, 10, 20, and 60 min at rest and 60 min coughing were found to be significantly higher in Control than in paravertebral block. A significant difference was revealed between Control vs. paravertebral block and paravertebral block vs. erector spinae plane in terms of total tramadol consumption (p=0.006). Total tramadol consumption in the first postoperative 24 h was significantly reduced in the paravertebral block compared with the Control and erector spinae plane groups. CONCLUSION: Sonography-guided-paravertebral block provides sufficient postoperative analgesia in laparoscopic cholecystectomy surgery. Erector spinae plane seems to attenuate total tramadol consumption.
目的:竖脊肌平面阻滞是一种比椎旁阻滞更新的方法,并发症风险更低。本研究旨在比较竖脊肌平面阻滞和椎旁阻滞,以在腹腔镜胆囊切除术病例中安全地达成最有效的镇痛方案。 方法:本研究纳入90例年龄在18 - 70岁之间、美国麻醉医师协会分级为I - II级的患者,他们接受了腹腔镜胆囊切除术。将他们随机分为三组,即对照组、竖脊肌平面阻滞组和椎旁阻滞组。对照组不进行阻滞操作,准备了一种患者自控镇痛装置,其中曲马多的单次推注剂量为10 mg,锁定时间为10分钟。术后24小时用视觉模拟量表记录疼痛评分。 结果:发现对照组在静息状态下1、5、10、20和60分钟以及咳嗽60分钟时的视觉模拟量表值显著高于椎旁阻滞组。在曲马多总消耗量方面,对照组与椎旁阻滞组以及椎旁阻滞组与竖脊肌平面阻滞组之间存在显著差异(p = 0.006)。与对照组和竖脊肌平面阻滞组相比,椎旁阻滞组术后24小时内曲马多的总消耗量显著降低。 结论:超声引导下椎旁阻滞在腹腔镜胆囊切除术中提供了充分的术后镇痛。竖脊肌平面阻滞似乎能减少曲马多的总消耗量。
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