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不同平面竖脊肌平面阻滞在腹腔镜胆囊切除术中镇痛效果的比较:一项随机对照试验

Comparison of analgesic efficacy of erector spinae plane block at different levels in laparoscopic cholecystectomies: a randomized controlled trial.

作者信息

Şehirlioğlu Serpil, Yaman Ümran, Gök Ayfer Kaya, Türkmen Ülkü Aygen, Moralar Döndü Genç, Özdemir Muhammed

机构信息

Department of Anesthesiology and Reanimation, Health Sciences University Gaziosmanpaşa Training and Research Hospital, İstanbul, Turkey.

Department of General Surgery, Health Sciences University Gaziosmanpaşa Training and Research Hospital, İstanbul, Turkey.

出版信息

BMC Anesthesiol. 2025 May 26;25(1):270. doi: 10.1186/s12871-025-03138-3.

Abstract

BACKGROUND

Erector Spinae Plane Block (ESPB) is employed as a component of multimodal analgesia in laparoscopic cholecystectomy (LC) procedures. The objective of this study is to assess the impact of ESPB performed at different levels during LC operations on postoperative pain scores and opioid consumption.

METHODS

A total of 103 patients undergoing LC were divided into three groups: Group Th7 (ESPB administered at the 7th thoracic vertebra level), Group Th9 (ESPB administered at the 9th thoracic vertebra level), and the control group. Patients were evaluated at 30 min, 1, 4, 8, 12, and 24 h postoperatively. Morphine consumption within the first 24 h postoperatively, resting and dynamic Numeric Rating Scale (NRS) scores, and complication rates were assessed.

RESULTS

When comparing morphine consumption among the groups, it was observed that patients who received ESP blocks had significantly lower morphine consumption at 1, 4, 8, 12, and 24 h compared to the control group. However, no significant difference was found between Group Th7 and Group Th9. In Group Th7 and Group Th9, the resting NRS scores at 30 min, 1, 4, and 24 h, as well as all dynamic NRS scores except at the 8th hour, were significantly lower compared to the control group. However, there was no significant difference between Group Th7 and Group Th9.

CONCLUSION

In LC surgeries, ESPB administered at the Th7 and Th9 levels exhibited similar analgesic efficacy. ESPB applied at the Th7 and Th9 levels can be utilized as part of multimodal analgesia.

摘要

背景

竖脊肌平面阻滞(ESPB)被用作腹腔镜胆囊切除术(LC)多模式镇痛的一个组成部分。本研究的目的是评估LC手术中不同水平实施的ESPB对术后疼痛评分和阿片类药物消耗量的影响。

方法

总共103例行LC手术的患者被分为三组:第7胸椎水平组(在第7胸椎水平给予ESPB)、第9胸椎水平组(在第9胸椎水平给予ESPB)和对照组。在术后30分钟、1小时、4小时、8小时、12小时和24小时对患者进行评估。评估术后24小时内的吗啡消耗量、静息和动态数字评分量表(NRS)评分以及并发症发生率。

结果

在比较各组间的吗啡消耗量时,发现接受ESPB阻滞的患者在术后1小时、4小时、8小时、12小时和24小时的吗啡消耗量明显低于对照组。然而,第7胸椎水平组和第9胸椎水平组之间未发现显著差异。在第7胸椎水平组和第9胸椎水平组中,术后30分钟、1小时、4小时和24小时的静息NRS评分以及除第8小时外的所有动态NRS评分均明显低于对照组。然而,第7胸椎水平组和第9胸椎水平组之间没有显著差异。

结论

在LC手术中,第7胸椎和第9胸椎水平实施的ESPB显示出相似的镇痛效果。在第7胸椎和第9胸椎水平应用的ESPB可作为多模式镇痛的一部分。

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