布比卡因脂质体竖脊肌平面阻滞对胸腔镜肺切除术患者术后恢复质量的影响  

Effect of bupivacaine liposome for erector spinae plane block on quality of postoperative recovery in patients undergoing thoracoscopic lung resection

作　　者：单希胜[1] 张扬 廖大为 胡晶辉 彭科[1] 刘华跃[1] 嵇富海[1] Shan Xisheng;Zhang Yang;Liao Dawei;Hu Jinghui;Peng Ke;Liu Huayue;Ji Fuhai(Department of Anesthesiology,The First Affliated Hospital of Soochow University,Institute of Anesthesioo gy,Soochow University,Suzhou 215006,China;Department of Anesthesiology,Tongren People's Hospital,Tongren 554300,China)

机构地区：[1]苏州大学附属第一医院麻醉手术科、苏州大学麻醉学研究所,苏州215006 [2]铜仁市人民医院麻醉科,铜仁554300

出　　处：《中华麻醉学杂志》2024年第10期1165-1169,共5页Chinese Journal of Anesthesiology

基　　金：江苏省卫健委医学科研面上项目(H2023019);苏州市医学创新应用研究(SKY2022138)。

摘　　要：目的探讨布比卡因脂质体竖脊肌平面阻滞对胸腔镜肺切除术后恢复质量的影响。方法选择2023年7月至2024年1月在苏州大学附属第一医院择期行胸腔镜肺切除术患者128例,性别不限,年龄18~75岁,ASA分级Ⅰ或Ⅱ级,BMI 18~32 kg/m^(2),采用随机数字表法将患者分为布比卡因脂质体组(BL组)和盐酸布比卡因组(BH组),每组64例。麻醉诱导后行超声引导下竖脊肌平面阻滞,BL组注射布比卡因脂质体20 ml(266 mg)+生理盐水10 ml,BH组注射盐酸布比卡因20 ml(100 mg)+生理盐水10 ml。主要指标:术后24 h时恢复质量-15量表(QoR-15)评分;次要指标:术后3 d时QoR-15评分、术后患者首次按压镇痛泵时间和术后3 d内阿片类药物用量;其他指标:下床活动时间、胸管留置时间、住院时间、出院时满意度评分及住院期间不良反应发生情况。结果与BH组比较,BL组患者术后24 h和3 d时QoR-15评分升高,术后首次按压镇痛泵时间延长,术后3 d内阿片类药物用量减少,下床活动时间缩短,出院时满意度评分升高(P<0.05)。2组患者胸管留置时间、住院时间和住院期间不良反应发生率比较差异无统计学意义(P>0.05)。结论布比卡因脂质体竖脊肌平面阻滞可提高胸腔镜肺切除术患者术后恢复质量。Objective:To investigate the effect of bupivacaine liposome for erector spinae plane block on the quality of postoperative recovery in patients undergoing thoracoscopic lung resection.Methods:From July 2023 to January 2024,128 American Society of Anesthesiologists Physical Status classificationⅠorⅡpatients of either sex,aged 18-75 yr,with body mass index of 18-32 kg/m^(2),scheduled for elective thoracoscopic lung resection at the First Affiliated Hospital of Soochow University,were assigned to either bupivacaine liposome group(BL group)or bupivacaine hydrochloride group(BH group)using a random number table method,with 64 patients in each group.Patients received an ultrasound-guided erector spinae plane block following anesthesia induction.BL group received an injection of bupivacaine liposome 20 ml(266 mg)plus normal saline 10 ml,while BH group received an injection of bupivacaine hydrochloride 20 ml(100 mg)plus normal saline 10 ml.The primary outcome was the Quality of Recovery-15(QoR-15)score at 24 h postoperatively.Secondary outcomes included the QoR-15 score at 3 days postoperatively,time to first patient-controlled analgesia press,and total opioid consumption within the first 3 days postoperatively.Other outcomes assessed were the time to ambulation,duration of chest tube placement,length of hospital stay,patient satisfaction scores at discharge,and development of adverse reactions during hospitalization.Results:Compared to BH group,QoR-15 scores were significantly increased at 24 h and 3 days postoperatively,the time to first patient-controlled analgesia press was significantly prolonged,the consumption of opioid was reduced within the first 3 days postoperatively,the time to ambulation was shortened,and patient satisfaction scores at discharge were increased in BL group(P<0.05).There were no statistically significant differences between the two groups in terms of the chest tube duration,length of hospital stay,and incidence of adverse reactions during hospitalization(P>0.05).Conclusions:Bupivacaine lip

关 键 词：布比卡因 脂质体 神经传导阻滞 胸腔镜 肺切除术 康复 竖脊肌 

分 类 号：R614[医药卫生—麻醉学]