超声引导下连续竖脊肌平面阻滞vs连续胸硬膜外镇痛治疗急慢性开胸术后疼痛:一项随机、对照、双盲试验

IF 3.4 Q2 NEUROSCIENCES
Ehab Hanafy Shaker, Mamdouh Mahmoud Elshal, Reham Mohamed Gamal, Norma Osama Abdallah Zayed, Samuel Fayez Samy, Raafat M. Reyad, Mohammed H. Shaaban, Abd Alrahman M. Abd Alrahman, Ahmed Salah Abdelgalil
{"title":"超声引导下连续竖脊肌平面阻滞vs连续胸硬膜外镇痛治疗急慢性开胸术后疼痛:一项随机、对照、双盲试验","authors":"Ehab Hanafy Shaker, Mamdouh Mahmoud Elshal, Reham Mohamed Gamal, Norma Osama Abdallah Zayed, Samuel Fayez Samy, Raafat M. Reyad, Mohammed H. Shaaban, Abd Alrahman M. Abd Alrahman, Ahmed Salah Abdelgalil","doi":"10.1097/pr9.0000000000001106","DOIUrl":null,"url":null,"abstract":"Abstract Introduction: Postthoracotomy pain (PTP) is a severe pain complicating thoracic surgeries and its good management decreases the risk of PTP syndrome (PTPS). Objectives: This randomized controlled study evaluated the efficacy of ultrasound-guided continuous erector spinae plane block (ESPB) with or without dexmedetomidine compared with thoracic epidural analgesia (TEA) in managing acute postoperative pain and the possible emergence of PTPS. Methods: Ninety patients with chest malignancies planned for thoracotomy were randomly allocated into 3 equal groups. Group 1: TEA (20 mL of levobupivacaine 0.25% bolus, then 0.1 mL/kg/h of levobupivacaine 0.1%), group 2: ESPB (20 mL of levobupivacaine only 0.1% bolus every 6 hours), and group 3: ESPB (20 mL of levobupivacaine 0.25% and 0.5 μg/kg of dexmedetomidine Hcl bolus every 6 hours). Results: Resting and dynamic visual analog scales were higher in group 2 compared with groups 1 and 3 at 6, 24, and 36 hours and at 8 and 12 weeks. Postthoracotomy pain syndrome incidence was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. The grading system for neuropathic pain score was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. Itching, pruritis, and urine retention were higher in group 1 than in ESPB groups. Conclusion: Ultrasound-guided ESPB with dexmedetomidine is as potent as TEA in relieving acute PTP and reducing the possible emergence of chronic PTPS. However, the 2 techniques were superior to ESPB without dexmedetomidine. Erector spinae plane block has fewer side effects compared with TEA.","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ultrasound-guided continuous erector spinae plane block vs continuous thoracic epidural analgesia for the management of acute and chronic postthoracotomy pain: a randomized, controlled,double-blind trial\",\"authors\":\"Ehab Hanafy Shaker, Mamdouh Mahmoud Elshal, Reham Mohamed Gamal, Norma Osama Abdallah Zayed, Samuel Fayez Samy, Raafat M. Reyad, Mohammed H. Shaaban, Abd Alrahman M. Abd Alrahman, Ahmed Salah Abdelgalil\",\"doi\":\"10.1097/pr9.0000000000001106\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Introduction: Postthoracotomy pain (PTP) is a severe pain complicating thoracic surgeries and its good management decreases the risk of PTP syndrome (PTPS). Objectives: This randomized controlled study evaluated the efficacy of ultrasound-guided continuous erector spinae plane block (ESPB) with or without dexmedetomidine compared with thoracic epidural analgesia (TEA) in managing acute postoperative pain and the possible emergence of PTPS. Methods: Ninety patients with chest malignancies planned for thoracotomy were randomly allocated into 3 equal groups. Group 1: TEA (20 mL of levobupivacaine 0.25% bolus, then 0.1 mL/kg/h of levobupivacaine 0.1%), group 2: ESPB (20 mL of levobupivacaine only 0.1% bolus every 6 hours), and group 3: ESPB (20 mL of levobupivacaine 0.25% and 0.5 μg/kg of dexmedetomidine Hcl bolus every 6 hours). Results: Resting and dynamic visual analog scales were higher in group 2 compared with groups 1 and 3 at 6, 24, and 36 hours and at 8 and 12 weeks. Postthoracotomy pain syndrome incidence was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. The grading system for neuropathic pain score was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. Itching, pruritis, and urine retention were higher in group 1 than in ESPB groups. Conclusion: Ultrasound-guided ESPB with dexmedetomidine is as potent as TEA in relieving acute PTP and reducing the possible emergence of chronic PTPS. However, the 2 techniques were superior to ESPB without dexmedetomidine. Erector spinae plane block has fewer side effects compared with TEA.\",\"PeriodicalId\":52189,\"journal\":{\"name\":\"Pain Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2023-11-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/pr9.0000000000001106\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/pr9.0000000000001106","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0

摘要

摘要简介:开胸术后疼痛(PTP)是胸外科手术中一种严重的并发症,良好的治疗可降低PTP综合征(PTPS)的发生风险。目的:本随机对照研究评估超声引导下连续勃起者脊柱平面阻滞(ESPB)加或不加右美托咪定与胸椎硬膜外镇痛(TEA)在治疗急性术后疼痛和可能出现的PTPS方面的疗效。方法:90例拟行开胸手术的胸部恶性肿瘤患者随机分为3组。第1组:TEA(0.25%左布比卡因20 mL丸,然后0.1%左布比卡因0.1 mL/kg/h),第2组:ESPB(0.1%左布比卡因20 mL丸,每6 h),第3组:ESPB(0.25%左布比卡因20 mL丸,每6 h右美托咪定0.5 μg/kg)。结果:在6、24、36小时和8、12周时,2组的静息和动态视觉模拟量表高于1、3组。8周和12周时,2组开胸后疼痛综合征发生率高于1组和3组,而1组和3组之间无差异。8周和12周时,2组神经病理性疼痛评分系统高于1组和3组,而1组和3组之间无差异。1组瘙痒、瘙痒、尿潴留发生率高于ESPB组。结论:超声引导下右美托咪定ESPB在缓解急性PTP和减少慢性PTP可能出现方面与TEA一样有效。但两种方法均优于不加右美托咪定的ESPB。与TEA相比,竖脊机脊柱平面阻滞的副作用更小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound-guided continuous erector spinae plane block vs continuous thoracic epidural analgesia for the management of acute and chronic postthoracotomy pain: a randomized, controlled,double-blind trial
Abstract Introduction: Postthoracotomy pain (PTP) is a severe pain complicating thoracic surgeries and its good management decreases the risk of PTP syndrome (PTPS). Objectives: This randomized controlled study evaluated the efficacy of ultrasound-guided continuous erector spinae plane block (ESPB) with or without dexmedetomidine compared with thoracic epidural analgesia (TEA) in managing acute postoperative pain and the possible emergence of PTPS. Methods: Ninety patients with chest malignancies planned for thoracotomy were randomly allocated into 3 equal groups. Group 1: TEA (20 mL of levobupivacaine 0.25% bolus, then 0.1 mL/kg/h of levobupivacaine 0.1%), group 2: ESPB (20 mL of levobupivacaine only 0.1% bolus every 6 hours), and group 3: ESPB (20 mL of levobupivacaine 0.25% and 0.5 μg/kg of dexmedetomidine Hcl bolus every 6 hours). Results: Resting and dynamic visual analog scales were higher in group 2 compared with groups 1 and 3 at 6, 24, and 36 hours and at 8 and 12 weeks. Postthoracotomy pain syndrome incidence was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. The grading system for neuropathic pain score was higher in group 2 compared with groups 1 and 3 at 8 and 12 weeks, whereas it was indifferent between groups 1 and 3. Itching, pruritis, and urine retention were higher in group 1 than in ESPB groups. Conclusion: Ultrasound-guided ESPB with dexmedetomidine is as potent as TEA in relieving acute PTP and reducing the possible emergence of chronic PTPS. However, the 2 techniques were superior to ESPB without dexmedetomidine. Erector spinae plane block has fewer side effects compared with TEA.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Pain Reports
Pain Reports Medicine-Anesthesiology and Pain Medicine
CiteScore
7.50
自引率
2.10%
发文量
93
审稿时长
8 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信