双侧棘突平面阻滞与芬太尼输注对经正中缝合的心脏手术术后恢复的影响：随机对照试验

IF 2.3 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-07-26 DOI:10.1053/j.jvca.2024.07.041

{"title":"双侧棘突平面阻滞与芬太尼输注对经正中缝合的心脏手术术后恢复的影响：随机对照试验","authors":"","doi":"10.1053/j.jvca.2024.07.041","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) on the time to extubation in patients who had undergone cardiac surgery through a midline sternotomy.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Cairo University Hospital and National Heart Institute, Egypt.</div></div><div><h3>Participants</h3><div>Patients aged 18 to 70 years who underwent a cardiac surgical procedure through a midline sternotomy.</div></div><div><h3>Interventions</h3><div>Recruited patients were randomized to receive either preoperative single-shot ultrasound-guided bilateral ESPB or fentanyl infusion.</div></div><div><h3>Measurements</h3><div>The primary outcome was the time to extubation. Other outcomes included total perioperative fentanyl consumption, pain score using the numerical rating score (NRS), length of intensive care unit (ICU) stay, and incidence of perioperative complications.</div></div><div><h3>Main Results</h3><div>Two hundred and nineteen patients were available for final analysis. The mean time to extubation was significantly shorter In the ESPB group compared to the control group (159.5 ± 109.5 minutes vs 303.2 ± 95.9 minutes; mean difference, -143.7 minutes; 95% confidence interval, -171.1 to -116.3 minutes; p = 0.0001). Ultra-fast track (immediate postoperative) extubation was achieved in 23 patients (21.1%) in the ESPB group compared to only 1 patient (0.9%) in the control group. The ICU stay was significantly reduced in the ESPB group compared to the control group (mean, 47.2 ± 13.3 hours vs 78.9 ± 25.2 hours; p = 0.0001). There was a more significant reduction in NRS in the ESPB group compared to the control group for up to 24 hours postoperatively (p = 0.001).</div></div><div><h3>Conclusions</h3><div>Among adult patients undergoing cardiac surgery through a midline sternotomy, the extubation time was halved in patients who received single-shot bilateral ESPB compared to patients who received fentanyl infusion.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Bilateral Erector Spinae Plane Block versus Fentanyl Infusion on Postoperative Recovery in Cardiac Surgeries via Median Sternotomy: A Randomized Controlled Trial\",\"authors\":\"\",\"doi\":\"10.1053/j.jvca.2024.07.041\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To assess the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) on the time to extubation in patients who had undergone cardiac surgery through a midline sternotomy.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Cairo University Hospital and National Heart Institute, Egypt.</div></div><div><h3>Participants</h3><div>Patients aged 18 to 70 years who underwent a cardiac surgical procedure through a midline sternotomy.</div></div><div><h3>Interventions</h3><div>Recruited patients were randomized to receive either preoperative single-shot ultrasound-guided bilateral ESPB or fentanyl infusion.</div></div><div><h3>Measurements</h3><div>The primary outcome was the time to extubation. Other outcomes included total perioperative fentanyl consumption, pain score using the numerical rating score (NRS), length of intensive care unit (ICU) stay, and incidence of perioperative complications.</div></div><div><h3>Main Results</h3><div>Two hundred and nineteen patients were available for final analysis. The mean time to extubation was significantly shorter In the ESPB group compared to the control group (159.5 ± 109.5 minutes vs 303.2 ± 95.9 minutes; mean difference, -143.7 minutes; 95% confidence interval, -171.1 to -116.3 minutes; p = 0.0001). Ultra-fast track (immediate postoperative) extubation was achieved in 23 patients (21.1%) in the ESPB group compared to only 1 patient (0.9%) in the control group. The ICU stay was significantly reduced in the ESPB group compared to the control group (mean, 47.2 ± 13.3 hours vs 78.9 ± 25.2 hours; p = 0.0001). There was a more significant reduction in NRS in the ESPB group compared to the control group for up to 24 hours postoperatively (p = 0.001).</div></div><div><h3>Conclusions</h3><div>Among adult patients undergoing cardiac surgery through a midline sternotomy, the extubation time was halved in patients who received single-shot bilateral ESPB compared to patients who received fentanyl infusion.</div></div>\",\"PeriodicalId\":15176,\"journal\":{\"name\":\"Journal of cardiothoracic and vascular anesthesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiothoracic and vascular anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1053077024005020\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiothoracic and vascular anesthesia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1053077024005020","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的评估超声引导下双侧竖脊肌平面阻滞（ESPB）对通过胸骨中线切口接受心脏手术的患者拔管时间的影响。干预措施招募的患者随机接受术前单次超声引导双侧ESPB或芬太尼输注。其他结果包括围手术期芬太尼总用量、数字评分法（NRS）疼痛评分、重症监护室（ICU）住院时间和围手术期并发症发生率。与对照组相比，ESPB 组的平均拔管时间明显缩短（159.5 ± 109.5 分钟 vs 303.2 ± 95.9 分钟；平均差异为-143.7 分钟；95% 置信区间为-171.1 至-116.3 分钟；P = 0.0001）。ESPB组有23名患者（21.1%）实现了超快速（术后立即）拔管，而对照组只有1名患者（0.9%）。与对照组相比，ESPB 组的重症监护室住院时间明显缩短（平均 47.2 ± 13.3 小时 vs 78.9 ± 25.2 小时；P = 0.0001）。结论在通过胸骨中线切口接受心脏手术的成人患者中，与接受芬太尼输注的患者相比，接受单次双侧ESPB的患者拔管时间缩短了一半。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effect of Bilateral Erector Spinae Plane Block versus Fentanyl Infusion on Postoperative Recovery in Cardiac Surgeries via Median Sternotomy: A Randomized Controlled Trial

Objective

To assess the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) on the time to extubation in patients who had undergone cardiac surgery through a midline sternotomy.

Design

Randomized controlled trial.

Setting

Cairo University Hospital and National Heart Institute, Egypt.

Participants

Patients aged 18 to 70 years who underwent a cardiac surgical procedure through a midline sternotomy.

Interventions

Recruited patients were randomized to receive either preoperative single-shot ultrasound-guided bilateral ESPB or fentanyl infusion.

Measurements

The primary outcome was the time to extubation. Other outcomes included total perioperative fentanyl consumption, pain score using the numerical rating score (NRS), length of intensive care unit (ICU) stay, and incidence of perioperative complications.

Main Results

Two hundred and nineteen patients were available for final analysis. The mean time to extubation was significantly shorter In the ESPB group compared to the control group (159.5 ± 109.5 minutes vs 303.2 ± 95.9 minutes; mean difference, -143.7 minutes; 95% confidence interval, -171.1 to -116.3 minutes; p = 0.0001). Ultra-fast track (immediate postoperative) extubation was achieved in 23 patients (21.1%) in the ESPB group compared to only 1 patient (0.9%) in the control group. The ICU stay was significantly reduced in the ESPB group compared to the control group (mean, 47.2 ± 13.3 hours vs 78.9 ± 25.2 hours; p = 0.0001). There was a more significant reduction in NRS in the ESPB group compared to the control group for up to 24 hours postoperatively (p = 0.001).

Conclusions

Among adult patients undergoing cardiac surgery through a midline sternotomy, the extubation time was halved in patients who received single-shot bilateral ESPB compared to patients who received fentanyl infusion.

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

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.