| 摘要: |
| 目的 比较两种不同路径的竖脊肌平面阻滞（Erector spinae plane block，ESPB）在胸腔镜手术术后的镇痛效果，为临床选择ESPB路径提供依据。方法 择期行胸腔镜下肺叶切除术患者90例，随机数字表法分成三组（n=30）：E组为竖脊肌深面与横突间隙阻滞组（入路1）；R组为菱形肌与竖脊肌间隙阻滞组（入路2）；C组为对照组。采用视觉模拟评分法（Visual analogue scale，VAS）观察并记录患者术后6h（T1）、12h（T2）、24 h（T3）和48 h（T4）静息状态及活动或咳嗽状态下患者的疼痛程度；比较各组术后补救镇痛情况以及不良反应的发生情况。结果 术后静息状态下，T1、T2和T3时点E组镇痛效果较R组和C组好（P<0.05），T1时点R组镇痛效果较C组好（P<0.05）；术后活动或咳嗽状态下，T1、T2和T3时点E组镇痛效果较R组和C组好（P<0.05），T1和T2时点R组镇痛效果较C组好（P<0.05）；T4时点三组都无明显差异（P>0.05）。与 C组比较，E组和R组术后48 h内补救镇痛次数减少、镇痛满意度评分升高（P<0.05）；与 R组比较，E组补救镇痛次数减少、镇痛满意度评分升高（P<0.05）。结论 两种不同入路ESPB均在一定程度上可减轻胸腔镜手术术后疼痛，减少术后镇痛药物的使用，且术中术后并发症少，其中竖脊肌深面与横突间隙阻滞入路为镇痛效果最佳入路。 |
| 关键词: 竖脊肌平面阻滞 术后镇痛 路径 肺叶切除术 胸腔镜 |
| DOI： |
| 分类号: |
| 基金项目: |
|
| Clinical study on analgesic effect of Erector Spinae Plane Block with two approaches after Thoracoscopic lobectomy |
|
wangjie
|
|
Binzhou Medical University
|
| Abstract: |
| Objective To compare the analgesic effects of two different approaches of Erector spinae plane block (ESPB) after thoracoscopic surgery, and to provide evidence for clinical selection of ESPB pathways. Methods Ninety patients undergoing elective thoracoscopic lobectomy were randomly divided into three groups (n=30) : group E was the deep surface of erector spinae and transversal space block group (approach 1); Group R was the rhomboid muscle and erector spinae space block group (approach 2); Group C was the control group. Visual analogue scale (VAS) was used to observe and record the pain degree of patients at rest and when active or coughing at 6h (T1), 12h (T2), 24 h (T3) and 48 h (T4) after operation. The postoperative remedial analgesia and the incidence of adverse reactions were compared between the groups. Results The analgesic effect of group E at T1, T2 and T3 was better than that of groups R and C (P<0.05), the analgesic effect of group R was better than that of group C at T1 (P<0.05); Under postoperative activity or cough, the analgesic effect of group E at T1, T2 and T3 was better than that of groups R and C (P<0.05), the analgesic effect of group R was better than that of group C at T1 and T2 (P<0.05); At T4, there was no significant difference among the three groups (P>0.05). Compared with group C, the number of remedial analgesia within 48 hours after operation in groups E and R was decreased and the satisfaction score of analgesia was increased (P<0.05); Compared with group R, the number of remedial analgesia was decreased and the satisfaction score of analgesia was increased in group E (P<0.05). Conclusions Two different approaches of ESPB can alleviate postoperative pain and reduce the use of postoperative analgesic drugs to a certain extent, with fewer intraoperative and postoperative complications, and approach 1 is the best approach for analgesic effect. |
| Key words: Erector spinae plane block Postoperative analgesia Approach Thoracoscopic lobectomy |
