Department of Anesthesiology, The Affiliated LiHuiLi Hospital of Ningbo University, No.57 Xingning Road, Ningbo, Zhejiang, 315040, China.
Health Science Center, Ningbo University, No.818 Fenghua Road, Ningbo, Zhejiang, 315211, China.
BMC Anesthesiol. 2024 Jun 3;24(1):196. doi: 10.1186/s12871-024-02586-7.
Erector spinae plane block (ESPB) is a novel fascial plane block technique that can provide effective perioperative analgesia for thoracic, abdominal and lumbar surgeries. However, the effect of cervical ESPB on postoperative analgesia after arthroscopic shoulder surgery is unknown. The aim of this study is to investigate the analgesic effect and safety of ultrasound-guided cervical ESPB in arthroscopic shoulder surgery.
Seventy patients undergoing arthroscopy shoulder surgery were randomly assigned to one of two groups: ESPB group (n = 35) or control group (n = 35). Patients in the ESPB group received an ultrasound-guided ESPB at the C7 level with 30 mL of 0.25% ropivacaine 30 min before induction of general anesthesia, whereas patients in the control group received no block. The primary outcome measures were the static visual analogue scale (VAS) pain scores at 4, 12, and 24 h after surgery. Secondary outcomes included heart rate (HR) and mean arterial pressure (MAP) before anesthesia (t1), 5 min after anesthesia (t2), 10 min after skin incision (t3), and 10 min after extubation (t4); intraoperative remifentanil consumption; the Bruggrmann comfort scale (BCS) score, quality of recovery-15 (QoR-15) scale score and the number of patients who required rescue analgesia 24 h after surgery; and adverse events.
The static VAS scores at 4, 12 and 24 h after surgery were significantly lower in the ESPB group than those in the control group (2.17 ± 0.71 vs. 3.14 ± 1.19, 1.77 ± 0.77 vs. 2.63 ± 0.84, 0.74 ± 0.66 vs. 1.14 ± 0.88, all P < 0.05). There were no significant differences in HR or MAP at any time point during the perioperative period between the two groups (all P > 0.05). The intraoperative consumption of remifentanil was significantly less in the ESPB group compared to the control group (P < 0.05). The scores of BCS and QoR-15 scale were higher in the ESPB group 24 h after surgery than those in the control group (P < 0.05). Compared to the control group, fewer patients in the ESPB group required rescue analgesia 24 h after surgery (P < 0.05). No serious complications occurred in either group.
Ultrasound-guided cervical ESPB can provide effective postoperative analgesia following arthroscopic shoulder surgery, resulting in a better postoperative recovery with fewer complications.
Chictr.org.cn identifier ChiCTR2300070731 (Date of registry: 21/04/2023, prospectively registered).
竖脊肌平面阻滞（ESPB）是一种新的筋膜平面阻滞技术，可为胸、腹和腰手术提供有效的围手术期镇痛。然而，超声引导下颈 ESPB 对肩关节镜手术后的术后镇痛效果尚不清楚。本研究旨在探讨超声引导下颈 ESPB 在肩关节镜手术中的镇痛效果和安全性。
70 例行肩关节镜手术的患者被随机分为两组：ESPB 组（n=35）或对照组（n=35）。ESPB 组患者在全身麻醉诱导前于 C7 水平行超声引导下 ESPB，注入 30ml0.25%罗哌卡因，对照组患者不进行阻滞。主要观察指标为术后 4、12 和 24 小时的静态视觉模拟评分（VAS）疼痛评分。次要观察指标包括麻醉前（t1）、麻醉后 5 分钟（t2）、皮肤切开后 10 分钟（t3）和拔管后 10 分钟（t4）的心率（HR）和平均动脉压（MAP）；术中瑞芬太尼消耗量；Bruggrmann 舒适度评分（BCS）、恢复质量-15 评分（QoR-15）评分和术后 24 小时需要补救镇痛的患者人数；以及不良事件。
与对照组相比，ESPB 组术后 4、12 和 24 小时的静态 VAS 评分明显更低（2.17±0.71 比 3.14±1.19，1.77±0.77 比 2.63±0.84，0.74±0.66 比 1.14±0.88，均 P<0.05）。两组在围手术期任何时间点的 HR 或 MAP 均无显著差异（均 P>0.05）。ESPB 组术中瑞芬太尼的消耗量明显少于对照组（P<0.05）。ESPB 组术后 24 小时 BCS 和 QoR-15 评分均高于对照组（P<0.05）。与对照组相比，ESPB 组术后 24 小时需要补救镇痛的患者更少（P<0.05）。两组均未发生严重并发症。
超声引导下颈 ESPB 可为肩关节镜手术后提供有效的术后镇痛，术后恢复更好，并发症更少。
Chictr.org.cn 标识符 ChiCTR2300070731（注册日期：2023 年 4 月 21 日，前瞻性注册）。
