Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Anesthesiology, Xingyi People's Hospital, the affiliated hospital of Guizhou Medical University, Xingyi, China.
Trials. 2024 Nov 16;25(1):776. doi: 10.1186/s13063-024-08449-3.
Open liver surgery remains a primary surgical approach for complex liver resections and liver transplantation. However, the postoperative pain management is still a major challenge. Ultrasound-guided external oblique intercostal (EOI) plane block is a novel approach of regional anaesthesia and has a great potential to relieve postoperative pain after upper abdominal surgeries. This study aims to investigate the efficacy and safety of ultrasound-guided EOI plane block in managing postoperative pain after open liver surgery.
Seventy-four participants scheduled for open liver surgery will be randomly assigned to either the intervention group, receiving an ultrasound-guided EOI plane block with a single dose of 30 ml 0.375% ropivacaine, or the control group, which will not receive this block. All participants will be provided with opioid-based patient-controlled intravenous analgesia (PCIA) postoperatively. The primary outcome is resting pain score at 3 h postoperatively, assessed using numerical rating scale. Secondary outcomes include pain score at 6, 24, 48, and 72 h postoperatively, perioperative opioid consumption, remedial analgesics within 72 h postoperatively, PCIA usage within postoperative 72 h, postoperative recovery, length of hospital stay, postoperative side effects, block-related complications, and ropivacaine plasma concentration of participants receiving the block.
This study is a randomised controlled trial to evaluate the efficacy and safety of ultrasound-guided EOI plane block for postoperative analgesia after open liver surgery. As regional anaesthesia plays an important role in the multimodal pain management, EOI plane block may prove to be an effective regional technique for enhancing postoperative pain relief and contributing to enhanced recovery after open liver surgery.
Chinese Clinical Trial Registry ChiCTR2200065745. Registered on November 14, 2022.
开腹肝切除术仍然是复杂肝切除术和肝移植的主要手术方法。然而，术后疼痛管理仍然是一个主要挑战。超声引导下的腹外斜肌肋间（EOI）平面阻滞是一种新的区域麻醉方法，对于缓解上腹部手术后的术后疼痛具有很大的潜力。本研究旨在探讨超声引导下 EOI 平面阻滞在开腹肝手术后管理术后疼痛的疗效和安全性。
74 名计划行开腹肝手术的患者将被随机分配到干预组或对照组。干预组接受单次 30ml 0.375%罗哌卡因的超声引导下 EOI 平面阻滞，对照组不接受此阻滞。所有患者术后均给予阿片类药物为基础的患者自控静脉镇痛（PCIA）。主要结局是术后 3 小时的静息疼痛评分，采用数字评分量表评估。次要结局包括术后 6、24、48 和 72 小时的疼痛评分、围手术期阿片类药物消耗、术后 72 小时内补救性镇痛药、术后 72 小时内 PCIA 使用、术后恢复、住院时间、术后副作用、阻滞相关并发症以及接受阻滞的患者的罗哌卡因血浆浓度。
本研究是一项随机对照试验，旨在评估超声引导下 EOI 平面阻滞在开腹肝手术后用于术后镇痛的疗效和安全性。由于区域麻醉在多模式疼痛管理中起着重要作用，EOI 平面阻滞可能被证明是一种有效的区域技术，可增强术后疼痛缓解，并有助于开腹肝手术后的快速康复。
中国临床试验注册中心 ChiCTR2200065745。注册于 2022 年 11 月 14 日。
