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不同容量竖脊肌平面阻滞对乳腺癌手术术中阿片类药物消耗和术后镇痛效果的影响:随机、前瞻性、双盲研究。

Investigation of efficacy of erector spinae plane block administered in different volumes on intraoperative opioid consumption and postoperative analgesia in breast surgery: Randomized, prospective, double-blind study.

作者信息

Solmaz Demirel Hasibe, Büyükbezirci Gülçin, Yılmaz Resul, Arıcan Şule, Eren Zeydoğlu Ayşe Seda, Reisli Ruhiye, Tuncer Uzun Sema

机构信息

Department of Anesthesiology and Reanimation, Beyhekim State Hospital, Konya, Türkiye.

Department of Anesthesiology and Reanimation, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Türkiye.

出版信息

Agri. 2024 Jul;36(3):146-155. doi: 10.14744/agri.2023.82346.

Abstract

OBJECTIVES

We investigated the efficacy of the erector spinae plane block, which has been proven to be effective in breast surgery, on intraoperative opioid consumption and postoperative analgesia when administered in different volumes with the same concentration of local anesthetic.

METHODS

This study is designed as randomized, prospective, and double-blind. Seventy patients aged between 18-70 years, undergoing ASA I-III elective breast surgery, were included. Unilateral erector spinae plane block was achieved by administering 20 mL of 0.375% bupivacaine hydrochloride in 35 patients in Group I and 30 mL of 0.375% bupivacaine hydrochloride in 35 patients in Group II. The analgesic requirement of the patients was monitored with the surgical plethysmographic index throughout the surgery. Intraoperative and postoperative opioid consumption, rescue analgesic requirements in the first 24 hours, and NRS scores at the 10th minute, 1st hour, 6th hour, 12th hour, and 24th hour postoperatively were recorded.

RESULTS

Both intraoperative and postoperative opioid consumptions were similar between groups (p>0.05). The number of involved dermatomes was significantly higher in Group II (p<0.05). No significant difference was found between postoperative NRS scores (p>0.05).

CONCLUSION

In elective breast surgery, erector spinae plane block administered at the same concentration in 20 or 30 mL volumes does not make a difference in opioid consumption and postoperative analgesia.

摘要

目的

我们研究了竖脊肌平面阻滞的效果,该阻滞在乳腺手术中已被证明是有效的,当以相同浓度的局麻药给予不同容量时,对术中阿片类药物的消耗和术后镇痛有影响。

方法

本研究设计为随机、前瞻性、双盲。纳入了 70 名年龄在 18-70 岁之间、接受 ASA I-III 级择期乳腺手术的患者。35 名患者在组 I 中接受 20 mL 0.375%盐酸布比卡因,35 名患者在组 II 中接受 30 mL 0.375%盐酸布比卡因进行单侧竖脊肌平面阻滞。在整个手术过程中,使用手术体积描记指数监测患者的镇痛需求。记录术中及术后阿片类药物的消耗、术后 24 小时内的解救镇痛需求以及术后第 10 分钟、第 1 小时、第 6 小时、第 12 小时和第 24 小时的 NRS 评分。

结果

两组患者的术中及术后阿片类药物消耗均无显著差异(p>0.05)。组 II 的涉及皮节数明显更高(p<0.05)。两组患者的术后 NRS 评分无显著差异(p>0.05)。

结论

在择期乳腺手术中,以相同浓度的 20 或 30 mL 容量给予竖脊肌平面阻滞,在阿片类药物消耗和术后镇痛方面没有差异。

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