超声引导竖脊机脊柱平面阻滞在胸腹外科手术中的疗效研究

Amol B Sasane
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摘要

背景:竖脊肌阻滞(ESPB)通过靶向脊神经的背支和腹支来提供镇痛,在腰椎区进行,用于腹胸手术术后镇痛。本研究旨在评估竖脊肌阻滞(Erector spinae block, ESPB)对全麻下腹胸手术患者术后镇痛的效果。材料和方法:本研究是一项前瞻性、随机、比较研究,在18-70岁的患者中进行,ASA分级- I/II,为胸腹外科手术,Mallampatti评分- I和II,同意参与。120例患者随机分为两组,每组60例,分别为Erector脊柱阻滞组(1组)和常规止痛药组(2组)。结果:两组患者的年龄、身高、体重、BMI等一般特征具有可比性,差异无统计学意义。术后收缩压、舒张压、心率及平均VAS评分从术后30分钟到480分钟(8小时),差异均有统计学意义。组1的阿片类药物需要量明显减少,因为没有患者需要注射曲马多超过100 mg,只有5例(8.33%)需要100 mg,而组2中73.33%的患者需要注射曲马多超过100 mg, 8.55%的患者需要175 mg。第1组有明显较长的阿片类药物空闲时间,前2小时没有患者需要注射曲马多,而第2组有83.33%的患者在前2小时需要注射曲马多。结论:超声引导下的竖脊肌阻滞镇痛效果优于全身镇痛,患者满意度和依从性更高
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study of efficacy of ultrasonography guided erector spinae plane block for abdominothoracic surgeries
Background: Erector spinae block (ESPB) provides analgesia by targeting the dorsal and ventral rami of the spinal nerves,performed in the lumbar region for postoperative analgesia of abdomino-thoracic surgeries. This study was aimed to assess the efficacy of Erector spinae block (ESPB) on postoperative analgesia in patients undergoing abdominothoracic surgeries under general anesthesia. Material and Methods: Present study was prospective, randomized, comparative study, conducted in patients with 18-70 years age, ASA grade- I/II, posted for abdominothoracic surgeries, Mallampatti scores - I and II, consented for participation. 120 patients were randomly assigned into two groups of 60 each, to either Erector spine block group (Group 1) or conventional pain killers (Group 2). Results: General characteristics such as age, height, weight, BMI were comparable in both groups and difference was not statistically significant. The postoperative systolic blood pressure, diastolic blood pressure, heart rate and Mean post-operative VAS score difference was statistically significant, from 30 minutes post-operative to 480 mins (8 hours). Group 1 have significantly less amount opioid requirement as none of the patients required inj tramadol more than 100 mg and only 5 (8.33%) cases required 100 mg whereas in the Group 2 73.33% required inj tramadol more than 100 mg and 8.55% required 175 mg. Group 1 have significantly long period of opioid free time as during first 2 hours none of the patients required inj tramadol whereas in the Group 2 83.33% required inj tramadol in the first 2 hours. Conclusion: In our study we concluded that the analgesic efficacy of Ultrasound guided Erector spinae block is an effective procedure over systemic analgesics and provide better patient satisfaction and compliance
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