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竖脊肌平面阻滞对行经皮肾镜取石术患者术后疼痛及康复质量的影响。

The effect of erector spinae plane block on postoperative pain and quality of recovery in patients undergoing percutaneous nephrolithotomy.

机构信息

Department of Urology, Afyonkarahisar Health Sciences University, 03100, Afyonkarahisar, Turkey.

Department of Urology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey.

出版信息

Sci Rep. 2024 Oct 24;14(1):25190. doi: 10.1038/s41598-024-77075-5.

DOI:10.1038/s41598-024-77075-5
PMID:39448703
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11502790/
Abstract

Percutaneous nephrolithotomy (PNL) is the preferred surgical procedure for treating renal stones larger than 2 cm. Patients may experience significant pain in the postoperative period due to factors such as the catheter entry site and tension in the renal capsule. Erector Spinae Plane (ESP) block provides perioperative muscle relaxation and reduces analgesic use. In this study, we investigated the effect of ESP block on postoperative pain scale and quality of recovery in patients undergoing PNL. The study was conducted with a total of 96 patients, with 45 patients receiving the ESP block and 51 patients not receiving the ESP block. Following the surgery, the visual pain scale (VAS) was completed at 0, 2, 6, 12, and 24 h, and the Quality of Recovery-15 (QoR-15) scale along with the willingness scale were completed at the 24-hour mark. The normal distribution of data was evaluated with the Kolmogorov-Smirnov test, histogram, and skewness-kurtosis coefficients. For comparing paired groups, the Student's T-test was used for normally distributed variables, while the Mann-Whitney U test was used for parameters that did not have a normal distribution. The comparison of postoperative pain, as measured by VAS scores between the groups, revealed statistically significantly lower scores in the ESP block group at 0, 2, 6, 12, and 24 h (p < 0.001, p < 0.001, p < 0.001, p = 0.008, p = 0.010, respectively). Our study results indicated that patients who received the ESP block experienced reduced pain levels and had higher QoR-15 scores compared to those who did not receive the ESP block.

摘要

经皮肾镜碎石术(PCNL)是治疗 2cm 以上肾结石的首选手术方法。由于导管入口部位和肾包膜张力等因素,患者术后可能会出现明显疼痛。竖脊肌平面(ESP)阻滞可提供围手术期肌肉松弛,减少镇痛药的使用。本研究旨在探讨 ESP 阻滞对接受 PCNL 患者术后疼痛评分和恢复质量的影响。研究共纳入 96 例患者,其中 45 例接受 ESP 阻滞,51 例未接受 ESP 阻滞。术后 0、2、6、12、24h 采用视觉模拟评分(VAS)评估疼痛,24h 时采用质量恢复量表(QoR-15)和意愿量表评估。采用 Kolmogorov-Smirnov 检验、直方图和偏度峰度系数评估数据正态分布。两组间配对比较采用学生 t 检验评估正态分布变量,采用 Mann-Whitney U 检验评估非正态分布参数。VAS 评分评估两组术后疼痛,ESP 阻滞组在 0、2、6、12、24h 的评分明显低于无 ESP 阻滞组(p<0.001,p<0.001,p<0.001,p=0.008,p=0.010)。研究结果表明,与未接受 ESP 阻滞的患者相比,接受 ESP 阻滞的患者疼痛程度降低,QoR-15 评分更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/ac1e3831320b/41598_2024_77075_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/2874e64189a2/41598_2024_77075_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/1027a78471ee/41598_2024_77075_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/ac1e3831320b/41598_2024_77075_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/2874e64189a2/41598_2024_77075_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/1027a78471ee/41598_2024_77075_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a81a/11502790/ac1e3831320b/41598_2024_77075_Fig3_HTML.jpg

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