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20或30毫升0.25%布比卡因竖脊肌平面阻滞在乳房切除术后提供等效的术后镇痛:一项前瞻性随机试验

The Erector Spinae Plane Block with 20 or 30 mL of 0.25% Bupivicaine Provides Equivalent Postoperative Analgesia after Mastectomy: A Prospective Randomized Trial.

作者信息

Bıdak Merve, Çiftçi Bahadır, Basım Pelin, Gölboyu Birzat Emre, Atalay Yunus Oktay

机构信息

İstanbul Medipol University Faculty of Medicine, Department of Anaesthesiology and Reanimation, İstanbul, Türkiye.

İstanbul Medipol University Faculty of Medicine, Department of General Surgery, İstanbul, Türkiye.

出版信息

Turk J Anaesthesiol Reanim. 2025 Feb 11;53(1):5-11. doi: 10.4274/TJAR.2024.241730.

Abstract

OBJECTIVE

Analgesia management following breast surgery is a critical concern. The erector spinae plane block (ESPB) is a regional anaesthesia technique that is frequently used for analgesia after breast surgery. However, there is no consensus on the volume. Therefore, the aim of this study was to compare ESPB performed using 20 mL vs. 30 mL.

METHODS

The study included 43 female patients with American Society of Anesthesiologist class I-II physical status. Participants were randomized into two groups: 20 mL ESPB and 30 mL ESPB. Ibuprofen (400 mg) 3x1 was ordered, and a fentanyl patient-controlled analgesia device was attached intravenously to the participants. If the pain score was ≥4, meperidine (0.5 mg kg) was administered.

RESULTS

Postoperative fentanyl use was similar between the groups. There was no difference in the amount of rescue analgesic use between the groups. The static and dynamic numerical rating scores were similar between the groups. No statistical difference was noted in terms of nausea, vomiting, or itching between the groups.

CONCLUSION

A similar analgesic effect is achieved by performing ESPB using 20 or 30 mL of local anaesthetic at the same concentration.

摘要

目的

乳房手术后的镇痛管理是一个关键问题。竖脊肌平面阻滞(ESPB)是一种区域麻醉技术,常用于乳房手术后的镇痛。然而,关于注射量尚无共识。因此,本研究的目的是比较使用20毫升与30毫升进行ESPB的效果。

方法

该研究纳入了43例美国麻醉医师协会身体状况分级为I-II级的女性患者。参与者被随机分为两组:20毫升ESPB组和30毫升ESPB组。医嘱给予布洛芬(400毫克),每日3次,并为参与者静脉连接芬太尼患者自控镇痛装置。如果疼痛评分≥4,则给予哌替啶(0.5毫克/千克)。

结果

两组术后芬太尼使用情况相似。两组间急救镇痛药使用量无差异。两组间静态和动态数字评分相似。两组在恶心、呕吐或瘙痒方面未观察到统计学差异。

结论

使用相同浓度的20毫升或30毫升局部麻醉药进行ESPB可达到相似的镇痛效果。

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