镇痛：疝修补术中神经阻滞的效果

本文由“小麻哥的日常"授权转载

摘要译文(供参考)

超声引导单侧竖脊肌平面阻滞用于腹腔镜腹股沟疝修补术的镇痛效果：

一项随机对照研究

背景：

尽管腹腔镜腹股沟疝修补术能更快地恢复日常活动，但术后疼痛控制不足会导致住院时间延长和患者不适。

竖脊肌平面阻滞（ESP）可用于腹部和胸部手术的术后疼痛管理。

我们研究了单侧ESP阻滞在腹腔镜疝手术中的应用效果。

方法：

共纳入60例择期行腹腔镜腹股沟疝手术的患者。

E组（n=30）在麻醉诱导后进行ESP阻滞。

C组（n=30）未进行干预。

术后疼痛由患者在术后1、4、6、12和24小时在麻醉后护理单元（PACU）使用数字评分量表（NRS）进行评估。

使用康复质量-40问卷评估术后功能恢复的质量。

结果：

在PACU、第1、4、6小时休息和运动时，E组（n=30）的NRS评分低于C组（n=30）。

术后24小时，ESP阻滞降低了曲马多的总消耗量[中位数（IQR），60（40）对85（30）]。

ESP组患者术后恢复质量评分优于对照组[平均值（SD），E组177.9（6.5），C组173.2（7.09），平均差异分别为4.633和95%（1.11至8.15）]。

讨论：

腹腔镜腹股沟疝手术中的单侧ESP阻滞可降低术后疼痛水平和镇痛药消耗。

此外，ESP阻滞可以安全地用于此类手术的疼痛管理，并提高恢复质量。

关键词：

术后急性疼痛；竖脊肌平面阻滞；腹股沟疝；术后恢复。

原文摘要

Analgesic efficacy of ultrasound guided unilateral erector spinae plane block for laparoscopic inguinal hernia repair:

a randomized controlled study

Background:

Although laparoscopic inguinal herniorrhaphy is associated with faster return to daily activity, inadequate postoperative pain control can cause prolonged hospital stays and patient discomfort. Erector spinae plane block (ESP) can be administered for postoperative pain management in abdominal and thoracic surgery. We investigated the effects of unilateral ESP block application in laparoscopic hernia surgery.

Methods:

A total of 60 patients who were scheduled for laparoscopic inguinal hernia surgery were included. ESP block was performed in group E (n = 30) after induction of anesthesia. There was no intervention in Group C (n = 30). Postoperative pain was assessed by the patient using the numeric rating scale (NRS) at postanesthetic care unit (PACU),1, 4, 6, 12, and 24 h after surgery. The quality of postoperative functional recovery was evaluated using the quality of recovery-40 questionnaire.

Results:

NRS scores were lower in Group E (n = 30) than in Group C (n = 30) at PACU, 1th, 4th, 6th hours in both rest and movement. Total tramadol consumption was reduced at postoperative 24 h by the ESP block [median(IQR), 60(40) versus 85(30)]. Quality of recovery score of the patients after operation was better in the ESP group than in the control group [mean(SD), 177.9(6.5) in group E and 173.2(7.09) in group C with mean differences: 4.633 and CI: 95% (1.11 to 8.15) respectively].

Discussion:

Unilateral ESP blocks in laparoscopic inguinal hernia surgery reduce both postoperative pain levels and analgesic consumption. In addition, the ESP block could be used safely in pain management of this type of surgery and improve the quality of recovery.

Keywords:

acute postoperative pain; Erector spinae plane block; inguinal hernia; postsurgical recovery.

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本微信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：Michel.米萱

校对：Mijohn.米江

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