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

Seyed Amirreza Akhlagh, Arash Farbood, Mahsa Tahvili, Afshin Amini, Keyvan Eghbal, Naeimehossadat Asmarian, Mahsa Banifatemi, Seyed Ali Hosseini
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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. 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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. 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引用次数: 0

摘要

背景。竖脊肌平面(ESP)阻滞是减少术后疼痛的一种新方法。我们研究了超声引导下双侧 ESP 阻滞在腰椎间盘切除术后 24 小时内减轻疼痛的疗效和副作用。材料和方法。我们在伊朗设拉子的 Shahid Chamran 医院对 50 名年龄在 18 岁至 65 岁之间、身体状况为美国麻醉学会 (ASA) I 级或 II 级、计划接受腰椎间盘切除手术的患者进行了单盲(统计分析师和负责术后记录患者信息的人员不知道研究小组)随机临床试验。患者被随机分配到 ESP 阻滞组(26 人)或对照组(24 人)。第一组患者在全身麻醉前接受双侧ESP阻滞,两组患者的麻醉方式相同。比较两组患者术后首次要求镇痛的时间、疼痛评分、阿片类药物总用量、副作用和患者满意度。结果显示与对照组相比,ESP阻滞组患者在术后第一小时和24小时内的疼痛缓解程度明显更高。ESP阻滞组的阿片类药物总用量更低。然而,ESP阻滞导致的尿潴留率较高。结论双侧 ESP 阻滞可有效减轻腰椎间盘切除术后的疼痛,最大限度地减少麻醉药物的使用。需要进一步研究如何减少作为主要并发症的尿潴留。本试验注册号为 IRCT20100127003213N6。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.
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