竖脊肌平面阻滞在腹部手术中的应用：荟萃分析

贵州医科大学     麻醉与心脏电生理课题组

翻译：邓举   编辑：张中伟  审核：曹莹

罂 粟 摘 要   

背景：腹部手术是临床上对腹部病变最明确和最主要的治疗方案之一。术后急性疼痛是术后管理的一个主要挑战。虽然阿片类药物经常常用于腹部大手术后的镇痛，但它们可能会出现副作用，如恶心和呕吐、便秘、瘙痒和危及生命的呼吸抑制。区域麻醉技术通常用于预防或减少这些副作用。本meta分析的目的是评估在腹部大手术后，竖脊肌平面阻滞(ESPB)和标准医疗（无阻滞）疼痛管理的有效性。

方法：我们搜索了在2021年5月之前发表的关于ESPB控制疼痛的随机对照试验的文章。

结果：系统检索最初发表56篇论文，排除49篇文章，纳入并分析7项随机临床试验。我们提取了ESPB组和无阻滞组术后阿片类药物消耗量、疼痛缓解效果、首次出现阿片类药物需求的时间、术后并发症发生率等数据。

结论：超声引导下的ESPB组的阿片类药物需求和首次镇痛需求的时间显著减少，但在汇总了阻滞和无阻滞研究的结果后，疼痛评分、恶心和呕吐没有显著差异。目前尚无关于与ESPB相关的严重并发症的报道。

原始文献来源：Viderman D, Aubakirova M ,Abdildin YG .Erector Spinae Plane Block in Abdominal Surgery: A Meta-Analysis.［J］Frontiers in Medicine(2022)9:812531.doi:10.3389/fmed.2022.812531 .

英文原文   

Erector Spinae Plane Block in

Abdominal Surgery: A Meta-Analysis

Abstract

Background:Abdominal surgery is one of the most definitive and mainstay treatment options for abdominal pathologies in clinical practice. Acute postoperative pain is a major challenge in the postoperative period. Although opioids are commonly used for analgesia after major abdominal surgeries, they can lead to side effects, such as nausea and vomiting, constipation, pruritus, and life-threatening respiratory depression. Regional anesthetic techniques are commonly used to prevent or minimize these side effects.The objective of this meta-analysis is to assess the effectiveness of erector spinae plane block (ESPB) and standard medical (no block) pain management after major abdominal surgeries.

Methods:We searched for articles reporting the results of randomized controlled trials on ESPB and no block in pain control published before May 2021.

Results: The systematic search initially yielded 56 publications, 49 articles were excluded, and seven randomized clinical trials were included and analyzed. We extracted the data on postoperative opioid consumption, the efficacy of pain relief, time to the first opioid demand, and the rate of postoperative complications in the ESPB group and no block group.

Conclusion: Opioid requirement and time to first analgesic request were significantly reduced in the ultrasound-guided ESPB group, but pain scores, nausea, and vomiting did not differ significantly after pooling the results of the block and no block studies. There were no reports on serious complications related to ESPB.

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