{"title":"脊柱手术后脊肌平面阻滞与静脉注射吗啡作为术后镇痛的比较研究","authors":"Khaled Mohamed, Hamza Hassan, Abo Alam, Mahmoud Mohamed Abo, Elhamd Abd, Elrahman, Khaled Abdelfattah, Mohamed Abdelfattah, Mohamed Abo Elhamd, Abd Elrahman","doi":"10.21608/ejhm.2024.348925","DOIUrl":null,"url":null,"abstract":"Background: Postoperative pain is defined as acute pain present at the surgical site or related to it after procedure. Objective: This work was aimed at performing a comparison between the erector spinae plane block (ESPB) impact in comparison with Intravenous morphine for postoperative analgesia following spine surgeries. Patients and Methods: This prospective randomized double-blind research included sixty individuals with ASA physical status class I and class II going through an uncomplicated spine surgery with general anesthesia. All participants went through a categorization into two equal groups; 30 in each. The first group patients were administered bilateral ultrasound guided ESPB utilizing plain bupivacaine at a dosage of 100 mg diluted to volume with saline, thus obtaining 50% concentration (50 mg plain bupivacaine in each side), The second group: received a dosage of 0.1 mg /kg of IV morphine diluted with saline to 10 ml volume when the surgical procedure is completed. Results: Postoperative heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), and visual analogue measurements (VAS) were significantly lower at 6h,12h and 24h within the first group as opposed to the second one (P value<0.05). Duration till the first analgesic need was significantly longer within group 1. Total paracetamol dosages within initial twenty-four hours postoperatively were significantly lower in group 1. PONV, hypotension and bradycardia were insignificantly varied among both groups. Conclusions: Using ESPB in spine surgeries is associated with better analgesic outcomes through pain score, duration till the first analgesia need and total paracetamol administration with no difference regarding complications compared to intravenous morphine.","PeriodicalId":22467,"journal":{"name":"The Egyptian Journal of Hospital Medicine","volume":"132 ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Study between Erector Spinae Plane Block versus Intravenous Morphine as Postoperative Analgesia after Spine Surgeries\",\"authors\":\"Khaled Mohamed, Hamza Hassan, Abo Alam, Mahmoud Mohamed Abo, Elhamd Abd, Elrahman, Khaled Abdelfattah, Mohamed Abdelfattah, Mohamed Abo Elhamd, Abd Elrahman\",\"doi\":\"10.21608/ejhm.2024.348925\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Postoperative pain is defined as acute pain present at the surgical site or related to it after procedure. Objective: This work was aimed at performing a comparison between the erector spinae plane block (ESPB) impact in comparison with Intravenous morphine for postoperative analgesia following spine surgeries. Patients and Methods: This prospective randomized double-blind research included sixty individuals with ASA physical status class I and class II going through an uncomplicated spine surgery with general anesthesia. All participants went through a categorization into two equal groups; 30 in each. The first group patients were administered bilateral ultrasound guided ESPB utilizing plain bupivacaine at a dosage of 100 mg diluted to volume with saline, thus obtaining 50% concentration (50 mg plain bupivacaine in each side), The second group: received a dosage of 0.1 mg /kg of IV morphine diluted with saline to 10 ml volume when the surgical procedure is completed. Results: Postoperative heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), and visual analogue measurements (VAS) were significantly lower at 6h,12h and 24h within the first group as opposed to the second one (P value<0.05). Duration till the first analgesic need was significantly longer within group 1. Total paracetamol dosages within initial twenty-four hours postoperatively were significantly lower in group 1. PONV, hypotension and bradycardia were insignificantly varied among both groups. Conclusions: Using ESPB in spine surgeries is associated with better analgesic outcomes through pain score, duration till the first analgesia need and total paracetamol administration with no difference regarding complications compared to intravenous morphine.\",\"PeriodicalId\":22467,\"journal\":{\"name\":\"The Egyptian Journal of Hospital Medicine\",\"volume\":\"132 \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Egyptian Journal of Hospital Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21608/ejhm.2024.348925\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Egyptian Journal of Hospital Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21608/ejhm.2024.348925","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:术后疼痛是指手术后出现在手术部位或与之相关的急性疼痛。研究目的本研究旨在比较竖脊肌平面阻滞(ESPB)与静脉注射吗啡对脊柱手术后镇痛的影响。患者和方法:这项前瞻性随机双盲研究纳入了 60 名 ASA 体力状态 I 级和 II 级的患者,他们都是在全身麻醉的情况下接受了不复杂的脊柱手术。所有参与者被分为两组,每组 30 人。第一组患者在超声引导下使用双侧ESPB,使用剂量为100毫克普通布比卡因,用生理盐水稀释至50%浓度(每侧50毫克普通布比卡因);第二组:手术完成后,使用剂量为0.1毫克/千克的静脉注射吗啡,用生理盐水稀释至10毫升。结果术后 6 小时、12 小时和 24 小时,第一组的心率(HR)、平均动脉压(MAP)、呼吸频率(RR)和视觉模拟测量值(VAS)均显著低于第二组(P 值<0.05)。第一组患者首次需要镇痛药的时间明显更长,第一组患者术后最初 24 小时内的扑热息痛总用量明显更少,两组患者的 PONV、低血压和心动过缓差异不大。结论:与静脉注射吗啡相比,在脊柱手术中使用ESPB可通过疼痛评分、首次镇痛需求前的持续时间和扑热息痛的总用量获得更好的镇痛效果,而并发症方面则没有差异。
Comparative Study between Erector Spinae Plane Block versus Intravenous Morphine as Postoperative Analgesia after Spine Surgeries
Background: Postoperative pain is defined as acute pain present at the surgical site or related to it after procedure. Objective: This work was aimed at performing a comparison between the erector spinae plane block (ESPB) impact in comparison with Intravenous morphine for postoperative analgesia following spine surgeries. Patients and Methods: This prospective randomized double-blind research included sixty individuals with ASA physical status class I and class II going through an uncomplicated spine surgery with general anesthesia. All participants went through a categorization into two equal groups; 30 in each. The first group patients were administered bilateral ultrasound guided ESPB utilizing plain bupivacaine at a dosage of 100 mg diluted to volume with saline, thus obtaining 50% concentration (50 mg plain bupivacaine in each side), The second group: received a dosage of 0.1 mg /kg of IV morphine diluted with saline to 10 ml volume when the surgical procedure is completed. Results: Postoperative heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), and visual analogue measurements (VAS) were significantly lower at 6h,12h and 24h within the first group as opposed to the second one (P value<0.05). Duration till the first analgesic need was significantly longer within group 1. Total paracetamol dosages within initial twenty-four hours postoperatively were significantly lower in group 1. PONV, hypotension and bradycardia were insignificantly varied among both groups. Conclusions: Using ESPB in spine surgeries is associated with better analgesic outcomes through pain score, duration till the first analgesia need and total paracetamol administration with no difference regarding complications compared to intravenous morphine.