Differences in Clinical Efficacy of Erector Spinae Plane Block Performed at the Medial and Lateral Transverse Processes: A Randomised Controlled Trial.

IF 0.7 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan Pub Date : 2025-05-01 DOI:10.29271/jcpsp.2025.05.556

Chen Chen, Hongyan Dai, Xiaoyang Jiang, Mayire Nuermaimaiti, Yanghao Ren, Tianhai Wang

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引用次数: 0

Abstract

Objective: To compare the clinical efficacy of erector spinae plane block (ESPB) administered at the medial versus lateral aspect of the fifth thoracic transverse process (TP) apex and to investigate the potential influence of the intermuscular partitioning fascia (IMPF) on medicine diffusion.

Study design: Randomised controlled trial. Place and Duration of the Study: Department of Anaesthesiology, Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang, China, from August 2023 to April 2024.

Methodology: Twenty patients undergoing thoracic surgery were randomly allocated to the medial TP apex group (M Group, n = 10) or lateral TP apex group (L Group, n = 10). ESPB was performed at the T5 level, and sensory blockade regions were evaluated 30 minutes post-injection.

Results: All patients in the M Group (10/10) exhibited sensory blockade covering the posterior midline to 2 cm laterally (L group: 0/10, p <0.001). The M Group also demonstrated a significantly higher blockade rate at the T11-T12 region (7/10 vs. 1/10, p = 0.020). Anatomical analysis indicated that the IMPF at the TP apex segregated medial and lateral medicine diffusion pathways.

Conclusion: ESPB administered at the medial TP apex provides a broader blockade range, potentially mediated by the IMPF restricting multidirectional medicine diffusion. This fascial barrier may influence clinical efficacy by directing medicine spread.

Key words: Erector spinae plane block, Transverse process, Ultrasound-guided, Fascial barrier, Sensory blockade.

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在内侧和外侧横突处进行竖脊肌平面阻滞的临床疗效差异：一项随机对照试验。

目的：比较竖脊平面阻滞（ESPB）在第5胸横突（TP）尖内侧与外侧的临床疗效，探讨肌间配筋膜（IMPF）对药物扩散的潜在影响。研究设计：随机对照试验。研究地点和时间：2023年8月至2024年4月，中国新疆新疆医科大学附属肿瘤医院麻醉科。方法：将20例胸外科手术患者随机分为内侧TP尖组（M组，n = 10）和外侧TP尖组（L组，n = 10）。在T5水平进行ESPB，并在注射后30分钟评估感觉封锁区域。结果：M组所有患者（10/10）均表现出覆盖后中线至外侧2cm的感觉阻滞（L组：0/10，p）。结论：在内侧TP尖给予ESPB提供了更广泛的阻滞范围，可能是由IMPF介导的，限制了药物的多向扩散。这种筋膜屏障可能通过指导药物的传播而影响临床疗效。关键词：竖脊肌平面阻滞，横突，超声引导，筋膜屏障，感觉阻滞。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jcpsp-Journal of the College of Physicians and Surgeons Pakistan MEDICINE, GENERAL & INTERNAL-

CiteScore

1.40

自引率

0.00%

发文量

453

审稿时长

3-6 weeks

期刊介绍： Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991. Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.