【罂粟摘要】前锯肌肋间筋膜间平面阻滞在上腹部手术中的应用:一项前瞻性随机对照试验

前锯肌肋间筋膜间平面阻滞在上腹部手术中的应用:一项前瞻性随机对照试验

贵州医科大学  麻醉与心脏电生理课题组

翻译：李奕    编辑：潘志军   审校：曹莹

背景：  

上腹部手术切口可能导致严重的术后疼痛。因此，充分的镇痛很重要。考虑到上腹部手术中阿片类药物的消耗、疼痛控制和恢复质量，我们研究了低位前锯肌-肋间筋膜间平面阻滞（SIPB）是否能实现有效镇痛。

方法：   这项盲法、随机对照研究对102名在全麻下接受开放性上腹壁手术的患者进行。将所有接受第八肋骨处接受锯缘-肋间平面阻滞作为镇痛技术的患者纳入SIPB组，对照组为持续静脉吗啡镇痛的患者。评估术后0、6、12、24和48小时的数字语言量表（NVS）疼痛评分和阿片类药物消耗量。术后24小时使用QoR-15问卷评估术后恢复质量。  

结果：

本研究显示，0组（SIPB）术后24小时阿片类药物消耗量较低（P<0.0001；4.17 mg vs.41.52 mg吗啡），疼痛控制较好（P<0.005），平均疼痛评分（NVs 1.8±1.5 vs.4.8±0.6）。SIPB组术后24小时的总体QoR-15评分更高（质量更好）（122vs.100）。

结论:

低位前锯肌-肋间筋膜间平面阻滞（SIPB）提供了有效的镇痛作用，从而节省阿片类药物，提高上腹部手术患者的恢复质量。

原始文献来源：

María T FernÁndez , Servando LÓpez , Jose A Aguirre, et al. Serratus intercostal interfascial plane block in supraumbilical surgery: a prospective randomized comparison.[J].Minerva Anestesiol. 2021 Feb;87(2):165-173.

罂粟花  

Serratus intercostal interfascial plane block in supraumbilical surgery: a prospective randomized comparison

Abstract

Background: Upper abdominal wall surgical incisions may lead to a severe postoperative pain. Therefore, adequate analgesia is important. Here we investigate whether the low serratus-intercostal interfascial plane block (SIPB) achieves an effective analgesia, considering opioids consumption, pain control and recovery quality in upper abdominal surgeries.

Method:This blinded, randomized controlled study was conducted on 102 patients undergoing open upper abdominal wall surgery under general anesthesia. All patients who received serratus-intercostal plane block at the eighth rib as analgesic technique were included in SIPB group and in control group those who received continuous intravenous morphine analgesia. Pain scores in numeric verbal scale (NVS) and opioids consumption at 0, 6, 12, 24 and 48 hours postoperatively were assessed. The quality of the postoperative recovery was evaluated using the QoR-15 questionnaire at 24 hours.

Results:This study showed lower postoperative opioid consumption at 24 hours (P<0.0001; 4.17 mg vs. 41.52 mg of morphine) and better pain control (P<0.005) with mean pain scores (NVS 1.8±1.5 vs. 4.8±1.6) in group 0 (SIPB). The global QoR-15 scores 24 hours postoperatively were higher (better quality) in the SIPB group (122 vs. 100).

Conclusion:The low serratus-intercostal interfascial plane block (SIPB) provides efficient analgesia leading to a saving of opioids and improvement of the recovery quality in patients undergoing upper abdominal wall surgeries.

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