单切口视频辅助胸腔镜手术中术后镇痛的超声引导单次注射脊柱平面阻滞、视网膜阻滞和椎旁阻滞的比较：三臂、双盲、随机对照非劣效性试验。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

Clinical Journal of Pain Pub Date : 2025-01-01 DOI:10.1097/AJP.0000000000001259

Yuyang Zhu, Yi Yang, Qinyu Zhang, Xuan Li, Wenqiang Xue, Yuan Liu, Yufei Zhao, Wenxia Xu, Peng Yan, Shuang Li, Yu Fang, Jie Huang

{"title":"单切口视频辅助胸腔镜手术中术后镇痛的超声引导单次注射脊柱平面阻滞、视网膜阻滞和椎旁阻滞的比较：三臂、双盲、随机对照非劣效性试验。","authors":"Yuyang Zhu, Yi Yang, Qinyu Zhang, Xuan Li, Wenqiang Xue, Yuan Liu, Yufei Zhao, Wenxia Xu, Peng Yan, Shuang Li, Yu Fang, Jie Huang","doi":"10.1097/AJP.0000000000001259","DOIUrl":null,"url":null,"abstract":"Objective: Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS).Methods: Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures.Results: The AUC for NRS was 107.8±10.53 in the ESPB group, 104.8±8.05 in the RLB group, and 103.6±10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2±3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2±2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events.Discussion: ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety.","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Ultrasound-guided Single-injection Erector Spinae Plane Block, Retrolaminar Block, and Paravertebral Block for Postoperative Analgesia in Single-incision Video-assisted Thoracoscopic Surgery: A 3-arm, Double-blind, Randomized Controlled Noninferiority Trial.\",\"authors\":\"Yuyang Zhu, Yi Yang, Qinyu Zhang, Xuan Li, Wenqiang Xue, Yuan Liu, Yufei Zhao, Wenxia Xu, Peng Yan, Shuang Li, Yu Fang, Jie Huang\",\"doi\":\"10.1097/AJP.0000000000001259\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS).Methods: Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures.Results: The AUC for NRS was 107.8±10.53 in the ESPB group, 104.8±8.05 in the RLB group, and 103.6±10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2±3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2±2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events.Discussion: ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety.\",\"PeriodicalId\":50678,\"journal\":{\"name\":\"Clinical Journal of Pain\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Journal of Pain\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/AJP.0000000000001259\",\"RegionNum\":3,\"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":"Clinical Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/AJP.0000000000001259","RegionNum":3,"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：有效的术后镇痛对胸外科手术至关重要。本研究比较了单切口视频辅助胸腔镜手术（SITS）中竖脊平面阻滞（ESPB）、后椎板阻滞（RLB）和椎旁阻滞（TPVB）的镇痛效果：76名患者在接受全身麻醉后，在超声引导下使用20毫升0.5%罗哌卡因进行神经阻滞。主要结果包括 24 小时内休息和咳嗽时数字评分量表（NRS）评分的曲线下面积（AUC）。次要结果包括围手术期阿片类药物的使用、血浆生物标志物和术后恢复指标：ESPB组NRS的AUC为107.8±10.53，RLB组为104.8±8.05，TPVB组为103.6±10.42，与TPVB相比，ESPB（差异：4.2±3.0，95% CI-1.82至10.22）和RLB（差异：1.2±2.6，95% CI-3.97至6.37）无劣效。在阿片类药物使用、血浆生物标志物、QoR-15评分或不良事件方面未观察到明显差异：讨论：与 TPVB 相比，ESPB 和 RLB 为 SITS 患者提供的镇痛效果并不逊色，而且是提高安全性的有效替代方案。

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

Comparison of Ultrasound-guided Single-injection Erector Spinae Plane Block, Retrolaminar Block, and Paravertebral Block for Postoperative Analgesia in Single-incision Video-assisted Thoracoscopic Surgery: A 3-arm, Double-blind, Randomized Controlled Noninferiority Trial.

Objective: Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS).

Methods: Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures.

Results: The AUC for NRS was 107.8±10.53 in the ESPB group, 104.8±8.05 in the RLB group, and 103.6±10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2±3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2±2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events.

Discussion: ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety.

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

Clinical Journal of Pain 医学-临床神经学

CiteScore

5.40

自引率

3.40%

发文量

118

审稿时长

4-8 weeks

期刊介绍： The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.