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竖脊肌平面阻滞与椎旁阻滞对肥胖患者行腹腔镜袖状胃切除术术后恢复质量的影响:一项随机对照试验。

Erector spinae plane block versus paravertebral block on postoperative quality of recovery in obese patients undergoing laparoscopic sleeve gastrectomy: a randomized controlled trial.

机构信息

Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.

出版信息

PeerJ. 2024 May 28;12:e17431. doi: 10.7717/peerj.17431. eCollection 2024.

Abstract

PURPOSE

To compare the impact of erector spinae plane block (ESPB) and paravertebral block (PVB) on the quality of postoperative recovery (QoR) of patients following laparoscopic sleeve gastrectomy (LSG).

METHODS

A total of 110 patients who underwent elective LSG under general anesthesia were randomly assigned to receive either ultrasound-guided bilateral ESPB or PVB at T8 levels. Before anesthesia induction, 40 mL of 0.33% ropivacaine was administered. The primary outcome was the QoR-15 score at 24 hours postoperatively.

RESULTS

At 24 hours postoperatively, the QoR-15 score was comparable between the ESPB and PVB groups (131 (112-140) 124 (111-142.5),  = 0.525). Consistently, there was no significant difference in QoR-15 scores at 48 hours postoperatively, numerical rating scale (NRS) pain scores at any postoperative time points, time to first ambulation, time to first anal exhaust, postoperative cumulative oxycodone consumption, and incidence of postoperative nausea and vomiting (PONV) between the two groups (all  > 0.05). No nerve block-related complications were observed in either group.

CONCLUSION

In patients undergoing LSG, preoperative bilateral ultrasound-guided ESPB yields comparable postoperative recovery to preoperative bilateral ultrasound-guided PVB.

摘要

目的

比较竖脊肌平面阻滞(ESPB)和椎旁阻滞(PVB)对腹腔镜袖状胃切除术(LSG)患者术后恢复质量(QoR)的影响。

方法

共 110 例行全身麻醉下择期 LSG 的患者被随机分为接受超声引导双侧 ESPB 或 T8 水平 PVB。在麻醉诱导前,给予 40ml0.33%罗哌卡因。主要结局是术后 24 小时的 QoR-15 评分。

结果

术后 24 小时,ESPB 和 PVB 组的 QoR-15 评分无显著差异(131(112-140)与 124(111-142.5),=0.525)。同样,术后 48 小时 QoR-15 评分、各术后时间点数字评分量表(NRS)疼痛评分、首次下床活动时间、首次排气时间、术后累积羟考酮消耗量以及术后恶心呕吐(PONV)发生率在两组间均无显著差异(均>0.05)。两组均未出现与神经阻滞相关的并发症。

结论

在接受 LSG 的患者中,术前双侧超声引导 ESPB 与术前双侧超声引导 PVB 相比,术后恢复情况相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7b8/11141559/e9995e7eac37/peerj-12-17431-g001.jpg

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