BACKGROUND Erector spinae plane block (ESPB) has been reported to manage postoperative pain effectively after various types of surgery. However, there has been a lack of study on the effect of ESPB after liver resection.

背景：竖脊肌平面阻滞(ESPB)已被报道可有效应用于各种手术后的术后疼痛。然而，关于肝切除术后ESPB效果的研究一直是缺乏报道。

OBJECTIVES To investigate the analgesic effects of ESPB on pain control after laparoscopic liver resection compared with conventional pain management.

目的：探讨腹腔镜下肝切除术后，与常规疼痛管理方法比较，使用竖脊肌平面阻滞控制疼痛的效果。

DESIGN Prospective, randomised controlled study.

设计：前瞻性、随机对照研究。

SETTINGA single tertiary care centre from February 2019 to February 2020.

试验地点和时间：三级医疗中心，从2019年2月至2020年2月。

PATIENTS A total of 70 patients scheduled to undergo laparoscopic liver resection.

病人：共有70例患者计划行腹腔镜肝切除术。

INTERVENTIONS In the control group (n=35), no procedure was performed. In the ESPB group (n=35), ESPB was performed after induction of general anaesthesia. A total of 40ml of ropivacaine 0.5% was injected at the T9 level bilaterally. After surgery, intravenous fentanyl patient-controlled analgesia was initiated. Fentanyl and hydromorphone were administered as rescue analgesics.

干预措施:对照组(n = 35)未进行疼痛干预。

ESPB组(n = 35)在全麻诱导后进行ESPB。共40ml 0.5%罗哌卡因在T9水平双侧注射。

手术后，开始使用芬太尼静脉自控镇痛。给予芬太尼和氢吗啡酮作为补救性镇痛药。

MAIN OUTCOME MEASURES The primary outcome was the cumulative postoperative opioid consumption at 24h (morphine equivalent). The secondary outcomes were rescue opioid (fentanyl) dose in the postanaesthesia care unit (PACU) and pain severity at 1, 6, 12, 24, 48 and 72h, assessed using a numerical rating scale (NRS) score.

主要结局指标：

主要结局指标是术后24小时阿片类药物累计消耗量(吗啡等效剂量)。

次要结局指标是麻醉后恢复室(PACU)的阿片类药物(芬太尼)补救性使用剂量和1、6、12、24、48和72小时的疼痛严重程度，使用数字评分量表(NRS)进行评估。

Table&Figure

RESULTS The median [IQR] cumulative postoperative opioid consumption at 24h was 48.2 [17.1] mg in the control group and 45.5 [35.8] mg in the ESPB group (median difference, 4.2 mg, 95% CI, －4.2 to 13.3 mg, P=0.259). Conversely, rescue opioid in PACU was 5.3 [5.0] mg in the control group and 3.0 [1.5] mg in the ESPB group (median difference 2.5mg, 95% CI, 1.0 to 5.0 mg, P<0.001). There was no significant difference in NRS scores point between the groups at any time.

结果：对照组术后24小时阿片类药物累计消耗量的中位数[四分位间距]为48.2 [17.1]mg, ESPB组为45.5 [35.8]mg(中位数差异，4.2 mg, 95% CI， －4.2—13.3 mg, P = 0.259)。

相反，PACU中阿片类药物补救性使用剂量在对照组中为5.3 [5.0]mg，在ESPB组中为3.0 [1.5]mg(中位数差异为2.5mg, 95% CI, 1.0—5.0 mg, P<0.001)。

两组在不同时间点的NRS评分无显著性差异。

CONCLUSION ESPB does not provide any measurable analgesic effect within 24h after laparoscopic liver resection.

结论：ESPB在腹腔镜肝切除术后24h内无明显镇痛作用。

• 所属分类：首页 > SCI期刊 > 医学

• 期刊名： EUROPEAN JOURNAL OF ANAESTHESIOLOGY

• 期刊名缩写：EUR J ANAESTH

• 国际刊号：0265-0215

• 2020年影响因子/JCR分区：4.500/Q3

• 出版国家或地区：ENGLAND

• 出版周期：Monthly

• 出版年份：1984

• 年文章数：74

• 是否OA开放访问：No

• 官方网站：journals.cambridge.org/action/displayJournal?jid=EJA