胸廓外科手术中脊柱前凸平面阻滞(ESPB)对手术相关应激反应的影响。

Pub Date : 2024-08-01 Epub Date: 2023-12-24 DOI:10.1080/00015458.2023.2297532
Ercan Albayrak, Emel Gündüz, Tülin Titiz, Ikbal Özen Küçükçetin
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引用次数: 0

摘要

背景:手术损伤会诱发手术应激反应,通过激活旨在恢复止血的内分泌、代谢和免疫介质诱导组织修复:我们的研究旨在确定镇痛方法对择期开胸手术患者术后呼吸功能测试、应激激素和促炎反应的影响。阻滞组中有 36 名患者接受了脊柱后凸肌平面阻滞,对照组中有 36 名患者接受了脊柱后凸肌平面阻滞。分别在术前、术后拔管后第 3 小时和术后第 24 小时测量 IL6、TNF α、皮质醇、CRP、胰岛素和血糖水平:我们观察到,ESPB组的IL6和TNFα水平与术前相比有所下降,而对照组的IL6和TNFα水平上升不明显:结论:ESPB 对应激激素和促炎细胞因子有积极影响,与无阻滞的患者相比,ESPB 可减少术中和术后阿片类药物和镇痛剂的使用,阻滞患者的 VAS 评分较低。
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The effects of erector spinae plane block (ESPB) on surgery-related stress response in thoracic surgery.

Background: Surgical injury induces a stress response to surgery that induces tissue repair with the activation of endocrine, metabolic, and immunological mediators aimed at restoring hemostasis.

Objective: In our study to determine the effect of analgesic method on postoperative respiratory function tests, stress hormone and proinflammatory response in patients undergoing elective thoracotomy surgery.

Methods: Seventy-two patients aged between 18 and 75 years with scheduled for elective thoracotomy surgery were included in the study. Thirty-six patients who underwent Erector Spinae Plane block were included in the block group, and 36 patients were included in the control group. IL 6, TNF alpha, cortisol, CRP, insulin and blood glucose levels were measured preoperatively, at the 3rd hour after postoperative extubation and at the 24th postoperative hour.

Results: We observed that while IL6 and TNF alpha levels decreased in the ESPB group compared to the preoperative period, they increased insignificantly in the control group.

Conclusion: ESPB has a positive effect on stress hormones and proinflammatory cytokines, reduces the use of opioids and analgesics in the intraoperative and postoperative period compared to patients without block, and lower VAS scores are obtained in patients with block.

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