双侧连续性竖脊肌平面阻滞用于心脏外科:病例系列

Q3 Medicine
I. F. Quintero-Cifuentes, Juan Camilo Clement, G. A. Cruz-Suárez, Katheryne Chaparro-Mendoza, Alejandra Holguín-Noreña, María A. Vélez-Esquivia
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引用次数: 0

摘要

胸骨切开术中多模式镇痛包括双侧连续竖脊肌平面阻滞(BC-ESPB)。然而,局部麻醉方案的有效性仍不确定。本研究的目的是评估多模式镇痛方案实现的疼痛控制,包括BC-ESPB在T5水平与0.125%布比卡因输注和救援丸PCA。这是一项描述性病例系列研究,在2021年2月至4月期间,在一家四级机构招募了11名通过胸骨切开术接受心脏手术的成年患者,其中使用了包括BC-ESPB在内的多模式镇痛。所有患者在休息和运动时、拔管时以及术后4和12小时均按照数值评定量表(NRS)≤3报告疼痛。24小时后,100%静息状态下的疼痛NRS≤3,63.6%运动状态下的疼痛NRS≤3。48小时时,81%的患者报告休息和运动时疼痛NRS≤3。在72小时,所有患者报告休息时疼痛NRS≤3,运动时疼痛NRS≤82%。术中芬太尼的平均使用量为2.35µg/kg,术后24、48和72小时氢吗啡酮的平均使用量分别为5.3、4.1和3.3 mg。因此,双侧ESP阻滞在持续输注和抢救丸中可以适当控制急性术中和术后疼痛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bilateral continuous erector spinae plane block for cardiac surgery: case series
Multimodal analgesia in cardiac surgery sternotomy includes bilateral continuous erector spinae plane block (BC-ESPB). However, the effectiveness of the local anesthetic regimens is still uncertain. The purpose of this study was to assess pain control achieved with a multimodal analgesia regimen including BC-ESPB at the level of T5 with PCA with a 0.125 % bupivacaine infusion and rescue boluses. This is a descriptive case series study which recruited 11 adult patients undergoing cardiac surgery through sternotomy in whom multimodal analgesia including BC-ESPB was used, between February and April 2021, at a fourth level institution. All patients reported pain according to the numeric rating scale (NRS)  ≤ 3 both at rest and in motion, at extubation and then 4 and 12 hours after surgery. After 24 hours the pain was NRS ≤ 3 in 100 % of the patients at rest and in 63.6 % in motion. At 48 h 81 % of the patients reported pain NRS ≤ 3 at rest and in motion. At 72h all patients reported pain NRS ≤ 3 at rest and 82 % in motion. The average intraoperative use of fentanyl was 2.35 µg/kg and postoperative hydromorphone was 5.3, 4.1 and 3.3 mg at 24, 48 and 72 hours, respectively. Hence, bilateral ESP block in continuous infusion plus rescue boluses allows for proper control of acute intra and post-operative pain.
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来源期刊
Colombian Journal of Anesthesiology
Colombian Journal of Anesthesiology Medicine-Critical Care and Intensive Care Medicine
CiteScore
1.70
自引率
0.00%
发文量
25
审稿时长
8 weeks
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