Department of Anesthesiology, Faculty of Medicine, Tanta University, Egypt.
Department of Surgical ICU and Pain Medicine, Faculty of Medicine, Tanta University, Egypt.
Ann Card Anaesth. 2024 Oct 1;27(4):316-323. doi: 10.4103/aca.aca_210_23. Epub 2024 Oct 4.
Ultrasound (US) guided erector spinae plane block (ESPB) is a safe and effective technique in providing perioperative pain management in pediatrics with a high success rate.
Was to compare the efficacy of bilateral ultrasound-guided erector spinae plane block for management of acute postoperative surgical pain after pediatric cardiac surgeries through a midline sternotomy.
One hundred patients aged 4-12 years were randomly assigned into two groups, both groups received general anesthesia followed by bilateral sham erector spinae plane block at the level of T6 transverse process using 0.4 ml/kg normal saline on each side in the control group (group C) or bilateral ultrasound-guided erector spinae plane block at the level of T6 transverse process using 0.4 ml/kg ropivacaine 0.2% with a maximum dose of 2 mg/kg mixed with adrenaline 2 mcg/ml in erector spinae plane block group (group E). The postoperative pain scores were evaluated immediately post-extubation, at 1 hour, 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, and 24 hours after extubation, total consumption of intraoperative fentanyl and time to first rescue analgesic administration were also recorded.
There was a statistically high significant delay in the group E (314.72 ± 45.94) compared with the group C (36.7 ± 7.22) as regards to the mean (SD) of the time of the rescue analgesia (P < 0.001) (with 95% CI), moreover; the number of rescue analgesic was significantly higher in the group C compared with the group E (P < 0.001) (with 95% CI) and the mean (SD) of total intraoperative and postoperative levels fentanyl requirements in the group C were significantly higher compared with the group E (6.47 ± 0.98 and 5.09 ± 0.83) (with 95% CI) in group C versus (4.69 ± 0.71 and 2.31 ± 0.66) (with 95% CI) in group E respectively (P < 0.001) (with 95% CI).
Ultrasound-guided bilateral ESPB with ropivacaine and adrenaline delays the postoperative need of analgesia and reduces postoperative fentanyl consumption at 24 h in pediatric patients undergoing cardiac surgery through midline sternotomy.
超声引导竖脊肌平面阻滞（ESPB）是一种安全有效的技术，可在儿科患者中提供围手术期疼痛管理，成功率高。
本研究旨在比较双侧超声引导竖脊肌平面阻滞在经中线胸骨切开术治疗小儿心脏手术后急性术后手术疼痛的疗效。
100 名年龄在 4-12 岁的患者随机分为两组，两组均接受全身麻醉，然后在对照组（C 组）双侧 T6 横突水平进行双侧假竖脊肌平面阻滞，每侧使用 0.4ml/kg 生理盐水，或在 E 组双侧 T6 横突水平使用 0.4ml/kg 罗哌卡因 0.2%加肾上腺素 2 mcg/ml 的超声引导竖脊肌平面阻滞。记录术后即刻、拔管后 1 小时、2 小时、4 小时、6 小时、8 小时、10 小时、12 小时、14 小时、16 小时、18 小时、20 小时、22 小时和 24 小时的术后疼痛评分，还记录术中芬太尼的总消耗量和首次解救镇痛的时间。
与 C 组（36.7±7.22）相比，E 组（314.72±45.94）的解救镇痛时间有统计学意义上的显著延迟（P<0.001）（95%CI）；与 E 组相比，C 组的解救镇痛次数明显更高（P<0.001）（95%CI），C 组术中及术后芬太尼总需求量明显高于 E 组（6.47±0.98 和 5.09±0.83）（95%CI），C 组（4.69±0.71 和 2.31±0.66）（95%CI）（P<0.001）（95%CI）。
在经中线胸骨切开术的小儿心脏手术中，超声引导双侧竖脊肌平面阻滞加罗哌卡因和肾上腺素可延迟术后镇痛需求，并减少术后 24 小时的芬太尼用量。
