双侧竖脊肌平面阻滞用于结直肠手术的镇痛效果

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双侧竖脊肌平面阻滞用于结直肠手术的镇痛效果：一项随机对照试验

背景：

结直肠癌很常见，对大多数患者来说手术是最有效的治疗方法。然而，大多数患者的术后疼痛管理通常是不充分的，本研究旨在确定作为多模式镇痛的一部分，超声(USG)引导的超前竖脊肌平面阻滞(ESPB)对结直肠癌手术患者术后镇痛的影响。

方法：

本研究是一项前瞻性、随机、单盲试验，包括60名在翁多库兹马伊斯大学医院接受结直肠手术的患者(ASA I-II级)。将患者分为ESP组和对照组。术中给予替诺昔康(20mg)和扑热息痛(1g)作为多模式镇痛的一部分，术后均给予吗啡静脉自控镇痛。主要结局是术后24小时内的吗啡总消耗量。次要结局包括术后前24小时和3个月静息、咳嗽和深吸气时的视觉模拟量表疼痛评分；要求急救镇痛的患者数量；恶心和呕吐的发生率以及是否需要止吐药；术中瑞芬太尼的用量；术后首次经口摄入；至首次排尿、首次排便和首次活动时间；住院时间；和瘙痒发生率。

结果：

ESP组术后6h吗啡用量、术后24h吗啡总用量、疼痛评分、术中瑞芬太尼用量、瘙痒发生率和术后止吐要求均低于对照组。阻滞组首次排便时间和住院时间较短。

结论：

作为多模式镇痛的一部分，ESPB降低了术后早期和第3个月的术后阿片类药物消耗和疼痛评分。

关键字：

结直肠外科；竖脊平面阻滞；疼痛；区域麻醉。

原文摘要

Analgesic efficacy of the bilateral erector spinae plane block for colorectal surgery: a randomized controlled trial

Background: Colorectal cancer is quite common, and surgery is the most effective treatment for most patients. However, postoperative pain management is generally inadequate in most patients. This study aimed to determine the effect of ultrasonography (USG)-guided preemptive erector spina plan block (ESPB), as part of multimodal analgesia, on postoperative analgesia in patients undergoing colorectal cancer surgery. METHODS: This is a prospective, randomized, single-blind trial. This study included 60 patients (ASA I-II) who underwent colorectal surgery at the hospital of Ondokuz Mayis University. The patients were divided into the ESP group and control group. Intraoperatively, all patients were administered intravenous tenoxicam (20 mg) and paracetamol (1 g) as part of multimodal analgesia. Intravenous morphine via patient-controlled analgesia was administered in all groups postoperatively. The primary outcome was the total morphine consumption in the first 24 h after surgery. The secondary outcomes included visual analog scale pain scores at rest and coughing and deep inspiration in the first 24 h and at 3 months postoperatively; number of patients requesting rescue analgesia; incidence of nausea and vomiting and need for antiemetics; intraoperative remifentanil consumption; postoperative first oral intake; time to first urination, first defecation, and first mobilization; hospitalization time; and incidence of pruritus.

Results: Morphine consumption in the first 6 h postoperatively, total amount of morphine consumed in the first 24 h postoperatively, pain scores, intraoperative remifentanil consumption, incidence of pruritus, and postoperative antiemetic requirement were lower in the ESP group than in the control group. First defecation time and hospitalization time were shorter in the block group.

Conclusions: As a part of multimodal analgesia, ESPB reduced postoperative opioid consumption and pain scores in the early postoperative period and in the 3rd month.

Keywords: Colorectal surgery; Erector spinae plane block; Pain; Regional anesthesia.

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本公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

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编辑：MiLu.米鹭

校对：Michel.米萱