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骶棘肌平面阻滞对全髋关节置换术后恢复质量的影响:一项前瞻性、随机、对照、多中心研究。

The effect of sacral erector spinae plane block on the quality of recovery after total hip arthroplasty: a prospective, randomized, controlled, multicenter study.

作者信息

Satici Muhammed H, Tutar Mahmut S, Tire Yasin, Binici Orhan, Çiçekler Osman, Korkmaz Elif, Pekince Oğuzhan, Kozanhan Betül

机构信息

Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Konya, Türkiye -

Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Konya, Türkiye.

出版信息

Minerva Anestesiol. 2025 Apr;91(4):278-285. doi: 10.23736/S0375-9393.24.18353-8. Epub 2024 Nov 4.

Abstract

BACKGROUND

Total hip arthroplasty, commonly performed to alleviate hip pain and enhance functionality in elderly patients, requires effective postoperative pain management to reduce opioid consumption and its associated side effects. A novel regional anaesthesia technique, the sacral erector spinae plane block, has the potential to enhance the quality of postoperative recovery significantly.

METHODS

This prospective, randomized, controlled multicenter study investigated the effects of the sacral erector spinae plane block on recovery quality in patients undergoing total hip arthroplasty. The study comprised 50 patients, divided into Group S (patients receiving patients receiving sacral erector spinae plane block [S-ESPB]) and Group C (patients getting just multimodal analgesia). The primary outcome measured was the Quality of Recovery-15 score 24 hours post-surgery. Secondary outcomes included postoperative numerical rating scale scores (A score of 0 indicates no pain, while 10 indicates the most severe pain), total consumption of rescue analgesics, time to first rescue analgesic administration, patient satisfaction, time to first ambulation, the occurrence of complications, and the need for antiemetics.

RESULTS

Group S had markedly higher quality of recovery-15 scores compared to Group C (Group S: median 117 percentiles [97-121]; Group C: median 89 percentiles [75-96]; P<0.001). Group S scored higher in postoperative pain, physical comfort, support, emotional state, and general quality of recovery-15 (P<0.001). Nevertheless, the physical independence category ratings were comparable across both groups (P=0.286).

CONCLUSIONS

Sacral erector spinae plane block is a promising analgesic technique that enhances postoperative recovery and patient comfort in total hip arthroplasty.

摘要

背景

全髋关节置换术常用于缓解老年患者的髋关节疼痛并提高其功能,术后需要有效的疼痛管理以减少阿片类药物的使用及其相关副作用。一种新型区域麻醉技术——骶棘肌平面阻滞,有可能显著提高术后恢复质量。

方法

这项前瞻性、随机、对照多中心研究调查了骶棘肌平面阻滞对全髋关节置换术患者恢复质量的影响。该研究包括50名患者,分为S组(接受骶棘肌平面阻滞[S-ESPB]的患者)和C组(仅接受多模式镇痛的患者)。主要观察指标是术后24小时的恢复质量-15评分。次要观察指标包括术后数字评分量表评分(0分表示无疼痛,10分表示最剧烈疼痛)、急救镇痛药的总消耗量、首次使用急救镇痛药的时间、患者满意度、首次下床活动的时间、并发症的发生情况以及使用止吐药的必要性。

结果

与C组相比,S组的恢复质量-15评分明显更高(S组:中位数117百分位数[97-121];C组:中位数89百分位数[75-96];P<0.001)。S组在术后疼痛、身体舒适度、支持度、情绪状态和恢复质量-15的总体评分方面得分更高(P<0.001)。然而,两组在身体独立性类别评分方面相当(P=0.286)。

结论

骶棘肌平面阻滞是一种有前景的镇痛技术,可提高全髋关节置换术的术后恢复和患者舒适度。

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