Li Qi, Zhang Liang, Zhou Hong-Mei, Wu Xin-Wei
Department of Anesthesiology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
Department of Anesthesiology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China; Department of Anesthesiology, Bengbu Medical College, Bengbu, Anhui, China.
J Arthroplasty. 2025 Apr;40(4):999-1004. doi: 10.1016/j.arth.2024.10.052. Epub 2024 Oct 19.
Total hip arthroplasty (THA) induces postoperative pain in elderly individuals. The erector spinae plane block (ESPB) is a novel analgesic approach for postoperative pain control. This randomized controlled trial evaluated the effectiveness of ultrasound-guided ESPB with ropivacaine in reducing pain in elderly patients undergoing THA.
Patients aged 60 to 80 years who had an American society of Anesthesiologists physical statuses I to III were eligible for this study. There were 50 patients who were randomized into two groups: the ESPB group receiving ultrasound-guided ESPB with ropivacaine, and the control group receiving ESPB with normal saline. All patients underwent general anesthesia, and the mean arterial pressure (MAP) heart rate (HR) intraoperative opioid consumption, numerical rating scale (NRS)scores, and postoperative adverse reactions were recorded throughout the perioperative period.
A significant reduction in NRS scores was observed in the ESPB group compared to the control group at various time points, including in the recovery room and at 12 and 24 hours postoperatively (P < 0.05). When the observation period was extended to 48 hours, no significant difference in NRS scores was noted between the two groups (P > 0.05). No significant differences in MAP and HR were found between the two groups, but the ESPB group showed lower coefficients of variation for both MAP and HR. Moreover, the ESPB group demonstrated significantly lower total remifentanil consumption than the control group. There was no significant difference in complications between these two groups (P < 0.05).
Ultrasound-guided ESPB enhances the perioperative stability of MAP and HR, providing effective analgesia within the initial 24 hours postsurgery, thereby reducing opioid requirements and improving overall postoperative recovery quality for elderly THA patients.
全髋关节置换术（THA）会导致老年患者术后疼痛。竖脊肌平面阻滞（ESPB）是一种用于术后疼痛控制的新型镇痛方法。本随机对照试验评估了超声引导下罗哌卡因ESPB在减轻老年THA患者疼痛方面的有效性。
年龄在60至80岁、美国麻醉医师协会身体状况分级为I至III级的患者符合本研究条件。50例患者被随机分为两组：ESPB组接受超声引导下罗哌卡因ESPB，对照组接受生理盐水ESPB。所有患者均接受全身麻醉，在整个围手术期记录平均动脉压（MAP）、心率（HR）、术中阿片类药物消耗量、数字评分量表（NRS）评分及术后不良反应。
与对照组相比，ESPB组在包括恢复室、术后12小时和24小时在内的各个时间点NRS评分均显著降低（P<0.05）。当观察期延长至48小时时，两组NRS评分无显著差异（P>0.05）。两组MAP和HR无显著差异，但ESPB组MAP和HR的变异系数较低。此外，ESPB组瑞芬太尼总消耗量显著低于对照组。两组并发症无显著差异（P<0.05）。
超声引导下ESPB可提高围手术期MAP和HR的稳定性，在术后最初24小时内提供有效的镇痛效果，从而减少阿片类药物需求，提高老年THA患者术后总体恢复质量。
