Suppr超能文献

一项比较超声引导下竖脊肌平面阻滞与胸腰筋膜间平面阻滞用于腰椎手术疗效的随机对照试验。

A Randomized Control Trial Comparing the Efficacy of Ultrasound-Guided Erector Spinae Plane Block With Thoracolumbar Interfascial Plane Block for Lumbar Spine Surgeries.

作者信息

Ratnam Manisha, Karthik Krishnamoorthy, Bhaskar Vishak M

机构信息

Anesthesiology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, IND.

出版信息

Cureus. 2024 Sep 30;16(9):e70478. doi: 10.7759/cureus.70478. eCollection 2024 Sep.

Abstract

Background Lumbar spine surgeries often involve significant postoperative pain, necessitating effective analgesic strategies. Erector spinae plane block (ESPB) and Thoracolumbar interfascial plane block (TLIPB) have emerged as promising regional anesthesia techniques for postoperative pain management. This study compares the efficacy of ultrasound-guided ESPB and TLIPB in providing analgesia following lumbar spine surgeries. Materials and methods A randomized controlled trial was conducted with 60 participants undergoing lumbar spine surgeries. Participants were randomized into ESPB and TLIPB, with 30 patients in each group using computer-generated random numbers with odd numbers allotted to Group A and even numbers allotted to Group B. Primary outcomes included postoperative visual analog pain scores, opioid consumption, and duration of analgesia. Secondary outcomes included time to block effectiveness and incidence of adverse events. Results Preliminary findings revealed that the ESPB group demonstrated significantly higher opioid consumption during the postoperative period, having Mean±SD 8.30±2.89 mg as compared to 6.43±2.85 mg found in the TLIPB group. Patient visual analog scores were higher in the ESPB group compared to the TLIPB group. Time to first analgesic request was more in the ESPB group, having Mean±SD 505.00±167.88 minutes compared to 435.33±181.01 minutes in the TLIPB group, indicating a potentially longer duration of block effectiveness. There were minimal adverse effects, which were similar in both groups. Conclusion Ultrasound-guided ESPB and TLIPB are both effective techniques for postoperative analgesia following lumbar spine surgeries. However, TLIP may offer advantages in terms of reduced opioid consumption after the patient starts complaining of pain, while ESPB provids more duration of analgesia as both the dorsal and ventral rami of spinal nerves are blocked. Further research with larger sample sizes is required to validate these findings and elucidate the optimal regional anesthesia technique for lumbar spine surgeries.

摘要

背景 腰椎手术术后常常伴有明显疼痛,因此需要有效的镇痛策略。竖脊肌平面阻滞(ESPB)和胸腰筋膜间平面阻滞(TLIPB)已成为术后疼痛管理中颇具前景的区域麻醉技术。本研究比较了超声引导下ESPB和TLIPB在腰椎手术后镇痛中的效果。

材料与方法 对60例接受腰椎手术的参与者进行了一项随机对照试验。参与者被随机分为ESPB组和TLIPB组,每组30例患者,使用计算机生成随机数,奇数分配给A组,偶数分配给B组。主要结局包括术后视觉模拟疼痛评分、阿片类药物消耗量和镇痛持续时间。次要结局包括阻滞起效时间和不良事件发生率。

结果 初步研究结果显示,ESPB组术后阿片类药物消耗量显著更高,平均±标准差为8.30±2.89mg,而TLIPB组为6.43±2.85mg。ESPB组患者的视觉模拟评分高于TLIPB组。ESPB组首次镇痛需求时间更长,平均±标准差为505.00±167.88分钟,而TLIPB组为435.33±181.01分钟,表明阻滞起效时间可能更长。不良反应极少,两组相似。

结论 超声引导下的ESPB和TLIPB都是腰椎手术后镇痛的有效技术。然而,TLIPB在患者开始主诉疼痛后可能在减少阿片类药物消耗方面具有优势,而ESPB由于同时阻滞了脊神经的背支和腹支,提供了更长的镇痛时间。需要更大样本量的进一步研究来验证这些发现,并阐明腰椎手术的最佳区域麻醉技术。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验