{"title":"双侧腰椎棘突平面阻滞对腰椎椎板切除术后疼痛的镇痛效果评估:单盲随机临床试验","authors":"Seyed Amirreza Akhlagh, Arash Farbood, Mahsa Tahvili, Afshin Amini, Keyvan Eghbal, Naeimehossadat Asmarian, Mahsa Banifatemi, Seyed Ali Hosseini","doi":"10.1155/2023/5813798","DOIUrl":null,"url":null,"abstract":"<i>Background</i>. The erector spinae plane (ESP) block is a novel approach to minimizing postoperative pain. We investigated the efficacy and side effects of the ultrasonography-guided bilateral ESP block in reducing pain in the first 24 hours after lumbar laminectomy. <i>Materials and Methods</i>. We conducted a single-blind (statistical analyst and those responsible for recording patient information postoperation were unaware of the study groups) randomized clinical trial on 50 patients aged 18 to 65 with American Society of Anesthesiology (ASA) class I or II physical status scheduled for lumbar laminectomy surgery at Shahid Chamran Hospital, Shiraz, Iran. Patients were randomly allocated to the ESP block (26 participants) or control (24 participants) group. A bilateral ESP block was administered to patients in the first group before general anesthesia, which was provided identically to both groups. The postoperative time to the first request of analgesia, pain score, total opioid use, side effects, and patient satisfaction were compared between the groups. <i>Results</i>. Compared with the control group, patients in the ESP block group had significantly more postoperative pain relief in the first hour and until 24 hours <span><svg height=\"11.5564pt\" style=\"vertical-align:-2.26807pt\" version=\"1.1\" viewbox=\"-0.0498162 -9.28833 23.787 11.5564\" width=\"23.787pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,4.498,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,16.156,0)\"></path></g></svg><span></span><span><svg height=\"11.5564pt\" style=\"vertical-align:-2.26807pt\" version=\"1.1\" viewbox=\"27.369183800000002 -9.28833 26.45 11.5564\" width=\"26.45pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,27.419,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,33.659,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,36.623,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,42.863,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,49.103,0)\"></path></g></svg>.</span></span> The total opioid consumption was lower in the ESP block group <span><svg height=\"11.5564pt\" style=\"vertical-align:-2.26807pt\" version=\"1.1\" viewbox=\"-0.0498162 -9.28833 23.787 11.5564\" width=\"23.787pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-41\"></use></g><g transform=\"matrix(.013,0,0,-0.013,4.498,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,16.156,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"11.5564pt\" style=\"vertical-align:-2.26807pt\" version=\"1.1\" viewbox=\"27.369183800000002 -9.28833 32.713 11.5564\" width=\"32.713pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,27.419,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,33.659,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,36.623,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,42.863,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,49.103,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,55.343,0)\"><use xlink:href=\"#g113-42\"></use></g></svg>.</span></span> However, the ESP block led to a higher rate of urinary retention <span><svg height=\"11.5564pt\" style=\"vertical-align:-2.26807pt\" version=\"1.1\" viewbox=\"-0.0498162 -9.28833 23.787 11.5564\" width=\"23.787pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-41\"></use></g><g transform=\"matrix(.013,0,0,-0.013,4.498,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,16.156,0)\"></path></g></svg><span></span><span><svg height=\"11.5564pt\" style=\"vertical-align:-2.26807pt\" version=\"1.1\" viewbox=\"27.369183800000002 -9.28833 32.713 11.5564\" width=\"32.713pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,27.419,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,33.659,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,36.623,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,42.863,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,49.103,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,55.343,0)\"><use xlink:href=\"#g113-42\"></use></g></svg>.</span></span> <i>Conclusion</i>. The bilateral ESP block effectively reduces postoperative pain following lumbar laminectomy, minimizing the need for narcotics. Further research is needed to delineate ways to reduce urinary retention as its main complication. This trial is registered with IRCT20100127003213N6.","PeriodicalId":501829,"journal":{"name":"Pain Research and Management","volume":"25 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessment of Analgesic Efficacy of Bilateral Lumbar Erector Spinae Plane Block for Postoperative Pain following Lumbar Laminectomy: A Single-Blind, Randomized Clinical Trial\",\"authors\":\"Seyed Amirreza Akhlagh, Arash Farbood, Mahsa Tahvili, Afshin Amini, Keyvan Eghbal, Naeimehossadat Asmarian, Mahsa Banifatemi, Seyed Ali Hosseini\",\"doi\":\"10.1155/2023/5813798\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Background</i>. The erector spinae plane (ESP) block is a novel approach to minimizing postoperative pain. We investigated the efficacy and side effects of the ultrasonography-guided bilateral ESP block in reducing pain in the first 24 hours after lumbar laminectomy. <i>Materials and Methods</i>. We conducted a single-blind (statistical analyst and those responsible for recording patient information postoperation were unaware of the study groups) randomized clinical trial on 50 patients aged 18 to 65 with American Society of Anesthesiology (ASA) class I or II physical status scheduled for lumbar laminectomy surgery at Shahid Chamran Hospital, Shiraz, Iran. Patients were randomly allocated to the ESP block (26 participants) or control (24 participants) group. A bilateral ESP block was administered to patients in the first group before general anesthesia, which was provided identically to both groups. The postoperative time to the first request of analgesia, pain score, total opioid use, side effects, and patient satisfaction were compared between the groups. <i>Results</i>. Compared with the control group, patients in the ESP block group had significantly more postoperative pain relief in the first hour and until 24 hours <span><svg height=\\\"11.5564pt\\\" style=\\\"vertical-align:-2.26807pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -9.28833 23.787 11.5564\\\" width=\\\"23.787pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,4.498,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,16.156,0)\\\"></path></g></svg><span></span><span><svg height=\\\"11.5564pt\\\" style=\\\"vertical-align:-2.26807pt\\\" version=\\\"1.1\\\" viewbox=\\\"27.369183800000002 -9.28833 26.45 11.5564\\\" width=\\\"26.45pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,27.419,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,33.659,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,36.623,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,42.863,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,49.103,0)\\\"></path></g></svg>.</span></span> The total opioid consumption was lower in the ESP block group <span><svg height=\\\"11.5564pt\\\" style=\\\"vertical-align:-2.26807pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -9.28833 23.787 11.5564\\\" width=\\\"23.787pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-41\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,4.498,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,16.156,0)\\\"><use xlink:href=\\\"#g117-91\\\"></use></g></svg><span></span><span><svg height=\\\"11.5564pt\\\" style=\\\"vertical-align:-2.26807pt\\\" version=\\\"1.1\\\" viewbox=\\\"27.369183800000002 -9.28833 32.713 11.5564\\\" width=\\\"32.713pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,27.419,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,33.659,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,36.623,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,42.863,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,49.103,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,55.343,0)\\\"><use xlink:href=\\\"#g113-42\\\"></use></g></svg>.</span></span> However, the ESP block led to a higher rate of urinary retention <span><svg height=\\\"11.5564pt\\\" style=\\\"vertical-align:-2.26807pt\\\" version=\\\"1.1\\\" viewbox=\\\"-0.0498162 -9.28833 23.787 11.5564\\\" width=\\\"23.787pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,0,0)\\\"><use xlink:href=\\\"#g113-41\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,4.498,0)\\\"><use xlink:href=\\\"#g113-81\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,16.156,0)\\\"></path></g></svg><span></span><span><svg height=\\\"11.5564pt\\\" style=\\\"vertical-align:-2.26807pt\\\" version=\\\"1.1\\\" viewbox=\\\"27.369183800000002 -9.28833 32.713 11.5564\\\" width=\\\"32.713pt\\\" xmlns=\\\"http://www.w3.org/2000/svg\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\"><g transform=\\\"matrix(.013,0,0,-0.013,27.419,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,33.659,0)\\\"><use xlink:href=\\\"#g113-47\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,36.623,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,42.863,0)\\\"><use xlink:href=\\\"#g113-49\\\"></use></g><g transform=\\\"matrix(.013,0,0,-0.013,49.103,0)\\\"></path></g><g transform=\\\"matrix(.013,0,0,-0.013,55.343,0)\\\"><use xlink:href=\\\"#g113-42\\\"></use></g></svg>.</span></span> <i>Conclusion</i>. The bilateral ESP block effectively reduces postoperative pain following lumbar laminectomy, minimizing the need for narcotics. Further research is needed to delineate ways to reduce urinary retention as its main complication. This trial is registered with IRCT20100127003213N6.\",\"PeriodicalId\":501829,\"journal\":{\"name\":\"Pain Research and Management\",\"volume\":\"25 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pain Research and Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/5813798\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain Research and Management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2023/5813798","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Assessment of Analgesic Efficacy of Bilateral Lumbar Erector Spinae Plane Block for Postoperative Pain following Lumbar Laminectomy: A Single-Blind, Randomized Clinical Trial
Background. The erector spinae plane (ESP) block is a novel approach to minimizing postoperative pain. We investigated the efficacy and side effects of the ultrasonography-guided bilateral ESP block in reducing pain in the first 24 hours after lumbar laminectomy. Materials and Methods. We conducted a single-blind (statistical analyst and those responsible for recording patient information postoperation were unaware of the study groups) randomized clinical trial on 50 patients aged 18 to 65 with American Society of Anesthesiology (ASA) class I or II physical status scheduled for lumbar laminectomy surgery at Shahid Chamran Hospital, Shiraz, Iran. Patients were randomly allocated to the ESP block (26 participants) or control (24 participants) group. A bilateral ESP block was administered to patients in the first group before general anesthesia, which was provided identically to both groups. The postoperative time to the first request of analgesia, pain score, total opioid use, side effects, and patient satisfaction were compared between the groups. Results. Compared with the control group, patients in the ESP block group had significantly more postoperative pain relief in the first hour and until 24 hours . The total opioid consumption was lower in the ESP block group . However, the ESP block led to a higher rate of urinary retention .Conclusion. The bilateral ESP block effectively reduces postoperative pain following lumbar laminectomy, minimizing the need for narcotics. Further research is needed to delineate ways to reduce urinary retention as its main complication. This trial is registered with IRCT20100127003213N6.