竖脊肌平面阻滞在胸腔镜肺切除手术中镇痛效果的评价  

Evaluation of the analgesic effect of erector spinae plane block in thoracoscopic unilateral pneumonectomy

作　　者：许楠 李润林[1] 刘昕[2] XU Nan;LI Runlin;LIU Xin(Department of Anesthesiology,Jiangdu People's Hospital of Yangzhou;Department of Anesthesiology,Subei People's Hospital of Jiangsu,Yangzhou 225200,China)

机构地区：[1]扬州市江都人民医院麻醉科 [2]江苏省苏北人民医院麻醉科,江苏扬州225200

出　　处：《麻醉安全与质控》2021年第6期329-332,共4页Perioperative Safety and Quality Assurance

基　　金：江苏省苏北人民院院课题基金(yzucms201708)。

摘　　要：目的观察超声引导下竖脊肌平面阻滞(ESPB)在胸腔镜单侧肺切除手术应用的镇痛效果,评估患者术后康复效应。方法选取2020年1~12月扬州市江都人民医院胸腔镜手术患者56例,随机分为ESPB组(n=28)与前锯肌平面阻滞(SAPB)组(n=28)。所有患者术后均接受静脉自控镇痛,观察各组阿片类药物用量,进行视觉模拟评分法(VAS)和恢复质量(QoR-15)评分。结果SAPB组与ESPB组和手术情况组一般资料比较差异无统计学意义(P>0.05)。与SAPB组比较,ESPB组术中瑞芬太尼用量和术后48 h内舒芬太尼总用量较低,差异有统计学意义(P<0.05)。与SAPB组比较,ESPB组在第1、2、16、48小时的静态与动态VAS评分均较低,差异有统计学意义(P<0.05)。ESPB组与SAPB组的QoR-15评分差异无统计学意义(P>0.05)。结论在胸腔镜单侧肺切除手术中,超声引导下的ESPB效果略优于SAPB,说明ESPB也是有效安全的镇痛方法。Objective To observe the analgesic effect of ultrasound-guided erector spinae plane block(ESPB)in thoracoscopic unilateral pneumonectomy,and evaluate its effect on the postoperative rehabilitation.Methods A total of 56 patients undergoing thoracoscopic unilateral pneumonectomy were randomly divided into ESPB group(n=28)and serratus anterior plane block group(SAPB group,n=28).All patients were received intravenous patient-controlled analgesia.Opioid consumption and adverse reactions in each group were observed,and visual analogue scale and quality of recovery-15(QoR-15)were performed.Results Compared with SAPB group,the amount of intraoperative remifentanil and the total amount of sufentanil within 48 h after operation were lower than those in ESPB group(P<0.05).Compared with SAPB group,the static and dynamic visual analogue scale scores of the ESPB group at 1,2,16 and 48 h were significant lower(P<0.05).There was no significant difference in QoR-15 score between ESPB group and SAPB group(P>0.05).Conclusion In thoracoscopic unilateral pneumonectomy,the analgesic effect of ultrasound-guided ESPB is slightly better than that of SAPB,indicating that ESPB is an effective and safe analgesic method.

关 键 词：竖脊肌平面阻滞 前锯肌平面阻滞 胸腔镜手术 镇痛 单侧肺切除 

分 类 号：R614[医药卫生—麻醉学]