[1]陶涛,周全.竖脊肌平面阻滞与后路椎板阻滞对后路腰椎手术术后镇痛效果的比较[J].南方医科大学学报,2019,(06):736.[doi:10.12122/j.issn.1673-4254.2019.06.17]
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竖脊肌平面阻滞与后路椎板阻滞对后路腰椎手术术后镇痛效果的比较()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2019年06期
页码:
736
栏目:
出版日期:
2019-06-16

文章信息/Info

Title:
Efficacy of erector spinae block versus retrolaminar block for postoperative analgesia following posterior lumbar surgery
作者:
陶涛周全
关键词:
竖脊肌平面阻滞后路椎板阻滞术后急性疼痛
Keywords:
erector spinae plane block retrolaminar block postoperative acute pain
DOI:
10.12122/j.issn.1673-4254.2019.06.17
摘要:
目的回顾性分析竖脊肌平面阻滞(ESPB)与后路椎板阻滞(RLB)对后路腰椎手术术后急性疼痛的影响。方法回顾性分 析2018年01月~2018年12月于我院行择期后路腰椎手术患者89例。其中,对照组30例,采用全凭静脉麻醉;ESPB组28例,采 用全凭静脉复合ESPB麻醉;RLB组31例,采用全凭静脉麻醉复合RLB麻醉。分别于术前和术后2、8、12、24、48 h对患者进行 VAS评分,记录患者术中和术后静脉镇痛舒芬太尼消耗量及术后48 h内恶心呕吐、瘙痒和呼吸抑制等并发症发生情况。结果 ESPB组和RLB组患者VAS评分在术后2、8和12 h 3个时间点显著低于对照组,而RLB组又低于ESPB组,差异具有统计学意 义(P<0.05)。与对照组相比,ESPB组和RLB组术中和术后静脉镇痛舒芬太尼消耗均显著减少,并且RLB组少于ESPB组,差异 具有统计学意义(P<0.05)。对照组出现2例恶心呕吐和1例瘙痒,ESPB组出现1例镇静过度和1例尿潴留,RLB组出现1例尿 潴留。结论在后路腰椎手术围术期疼痛管理中,超声引导下RLB较ESPB具有更好的镇痛效果。
Abstract:
Objective To compare the effect of erector spinae plane block and retrolaminar block for relieving acute pain after posterior lumbar surgery. Methods Eighty-nine patients undergoing selective posterior lumbar surgery under general anesthesia in our hospital between January and December, 2018, were recruited. Of these patients, 30 received total intravenous general anesthesia to serve as the control group, 28 received total intravenous general anesthesia (TIVA) combined with erector spinae plane block (ESPB), and 31 had TIVA combined with retrolaminar block (RLB). All the patients received patient-controlled intravenous analgesia (PCIA) for postoperative analgesia, and their heart rate, blood pressure, and pulse oximetry were routinely monitored during the anesthesia. VAS scores were evaluated before and at 2, 8, 12, 24, and 48 h after the surgery. Sufentanil consumption during the operation and PCIA were also recorded. The postoperative complications such as nausea and vomiting, urinary retention, itching and respiratory depression within 48 h after the surgery were also recorded. Results At 2, 8 and 12 h postoperatively, VAS scores in the ESPB group and RLB group were significantly lower than those in the control group; the scores were significantly lower in RLB group than in ESPB group (P<0.05). Compared with that in the control group, sufentanil consumption during the operation and PCIA were significantly decreased in both ESPB and RLB groups, particularly in the latter group (P<0.05). Two patients experienced nausea and vomiting and 1 patient complained of pruritus in control group; 1 patient had over sedation and 1 had urinary retention in ESPB group; 1 patient had urinary retention in RLB group. Conclusion Ultrasound-guided RLB has better analgesic effect than ESPB for management of perioperative pain following posterior lumbar surgery.
更新日期/Last Update: 1900-01-01