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超声引导下竖脊肌平面阻滞用于电视胸腔镜手术的阿片类药物节省效应:一项随机对照研究

Opioid-sparing effects of ultrasound-guided erector spinae plane block for video-assisted thoracoscopic surgery: a randomized controlled study.

作者信息

Xu Huan, Wu Wei, Chen Xue, He Wenxin, Shi Hong

机构信息

Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.

出版信息

Perioper Med (Lond). 2024 Jun 7;13(1):53. doi: 10.1186/s13741-024-00413-8.

Abstract

BACKGROUND

The erector spinae plane block (ESPB) is a new analgesic method used in thoracic surgery. However, few studies have characterized their effects on perioperative opioid consumption. We aimed to evaluate the effects of ESPB on perioperative opioid consumption in patients who underwent video-assisted thoracoscopic surgery (VATS).

METHODS

This was a randomized, observer-blinded clinical trial at a single-centre academic hospital. Eighty patients were scheduled for thoracoscopic segmentectomy or lobectomy by VATS for lung cancer. Forty participants were randomly assigned to ESPB or control group. All patients received intravenous patient-controlled postoperative analgesia. Perioperative opioid consumption, visual analogue scale (VAS) scores, and adverse events were recorded.

RESULTS

Intraoperative and postoperative opioid consumption and static/dynamic VAS scores were significantly lower in the early hours after VATS in the ESPB group (p < 0.05) than the control group. No significant differences were observed in adverse effects between the two groups.

CONCLUSIONS

ESPB reduced intraoperative opioid consumption and early postoperative pain in patients undergoing VATS. Our findings support the view that ESPB is a safe and highly effective option for regional analgesia for VATS.

TRIAL REGISTRATION

http://www.chictr.org.cn , ChiCTR1800019335.

摘要

背景

竖脊肌平面阻滞(ESPB)是一种用于胸外科手术的新型镇痛方法。然而,很少有研究描述其对围手术期阿片类药物消耗的影响。我们旨在评估ESPB对接受电视辅助胸腔镜手术(VATS)患者围手术期阿片类药物消耗的影响。

方法

这是一项在单中心学术医院进行的随机、观察者盲法临床试验。80例计划接受VATS肺癌胸腔镜节段切除术或肺叶切除术的患者。40名参与者被随机分配到ESPB组或对照组。所有患者均接受静脉自控术后镇痛。记录围手术期阿片类药物消耗、视觉模拟量表(VAS)评分和不良事件。

结果

ESPB组VATS术后早期的术中及术后阿片类药物消耗以及静态/动态VAS评分均显著低于对照组(p < 0.05)。两组之间在不良反应方面未观察到显著差异。

结论

ESPB减少了接受VATS患者的术中阿片类药物消耗和术后早期疼痛。我们的研究结果支持ESPB是VATS区域镇痛的一种安全且高效选择的观点。

试验注册

http://www.chictr.org.cn ,ChiCTR1800019335。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/492a/11161975/3b6fc13538d1/13741_2024_413_Fig1_HTML.jpg

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