双侧勃起棘平面阻滞在腹腔镜胆囊切除术患者围手术期减少阿片类药物给药的有效性

IF 1 4区医学 Q3 EMERGENCY MEDICINE

Signa Vitae Pub Date : 2021-09-15 DOI:10.22514/sv.2021.164

F. Sifaki, I. Mantzoros, E. Koraki, S. Bagntasarian, P. Christidis, Vaia Tsapara, K. Theodoraki

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引用次数: 0

摘要

引言：腹腔镜胆囊切除术（LC）是普通外科中最常见的手术之一。大多数情况下，LC伴有中度至重度的术后疼痛。勃起棘平面阻滞（ESPB）是一种创新的躯干阻滞，已被用作各种临床手术的术后镇痛方法。在本研究中，我们评估了它作为围手术期镇痛方法的有效性，试图调查它是否能有效减少LC患者围手术期阿片类药物的使用。方法：这是一项双盲、随机、对照的前瞻性研究。60例患者随机分为C组（N/S 0.9%的ESPB）、D组（0.375%的罗哌卡因，右美托咪定1γ/kg的ESPB和0.375%的罗哌卡因，R组）。统计分析包括方差分析、重复测量的双向方差分析、Kruskal-Wallis和Spearman检验。结果：所有患者在住院期间均保持血液动力学稳定，无重大并发症。三组患者围手术期瑞芬太尼总消耗量存在统计学意义。发现D组患者的中位吗啡消耗量、NRS疼痛评分和动员时间与C组患者相比显著减少，R组患者与C组相比显著减少。然而，D组和R组之间没有统计学上重要的差异。与C组患者相比，D组患者的满意度得分在统计学上更高。结论：在LC患者中使用罗哌卡因或罗哌卡因与右美托咪定联合用药的ESPB表现是一种创新、安全和简单的方法，有助于提高围手术期镇痛质量，避免阿片类药物给药引起的并发症，从而实现多模式镇痛。

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The effectiveness of Bilateral Erector Spinae Plane Block in reducing perioperative opioid administration in patients undergoing Laparoscopic Cholecystectomy

Introduction: Laparoscopic cholecystectomy (LC), is one of the most common surgeries performed in general surgery. Most of the times, LC is accompanied by moderate to severe postoperative pain. Erector Spinae Plane Block (ESPB) is an innovative trunk block which has been used as a method of postoperative analgesia in various clinical procedures. In this study we evaluated its effectiveness as a method of perioperative analgesia, seeking to investigate whether it is effective in reducing perioperative opioid administration in patients undergoing LC. Methods: This is a double-blind, randomized, controlled, prospective study. 60 patients were randomized into Group C (ESPB with N/S 0.9%), Group D (ESPB with ropivacaine 0.375%, dexmedetomidine 1 γ/kg) and Group R (ESPB with ropivacaine 0.375%). ESPB was performed bilaterally before induction of general anesthesia, with ultrasound guidance. Statistical analysis included ANOVA, two-way ANOVA for repeated measures, Kruskal-Wallis and Spearman tests. Results: All patients remained hemodynamically stable during their hospitalization, without major complications. Statistical significance was found to exist regarding total perioperative remifentanil consumption between all three Groups. Median morphine consumption, NRS pain scores and mobilization time of the patients was found to be significantly less in patients of Group D compared with patients of Group C and in patients of Group R compared with patients of Group C. However, there was no statistically important difference between Groups D and R. Satisfaction scores were found to be statistically higher in patients of Group D when compared with patients of Group C. Conclusion: ESPB performance with administration of ropivacaine or a combination of ropivacaine and dexmedetomidine in patients undergoing LC, is an innovative, safe and simple method which contributes to the amelioration of the quality of perioperative analgesia, avoiding the complications arising from opioid administration and thus, achieving multimodal analgesia.

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来源期刊

Signa Vitae 医学-急救医学

CiteScore

1.30

自引率

9.10%

发文量

审稿时长

3 months

期刊介绍： Signa Vitae is a completely open-access，peer-reviewed journal dedicate to deliver the leading edge research in anaesthesia, intensive care and emergency medicine to publics. The journal’s intention is to be practice-oriented, so we focus on the clinical practice and fundamental understanding of adult, pediatric and neonatal intensive care, as well as anesthesia and emergency medicine. Although Signa Vitae is primarily a clinical journal, we welcome submissions of basic science papers if the authors can demonstrate their clinical relevance. The Signa Vitae journal encourages scientists and academicians all around the world to share their original writings in the form of original research, review, mini-review, systematic review, short communication, case report, letter to the editor, commentary, rapid report, news and views, as well as meeting report. Full texts of all published articles, can be downloaded for free from our web site.