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  • 金杨,江雪梅,孙梦,等.超声引导下竖脊肌平面阻滞和椎旁神经阻滞对VATS患者术后镇痛和恢复影响的比较[J].同济大学学报(医学版),2020,41(2):216-220.    [点击复制]
  • JIN Yang,JIANG Xue-mei,SUN Meng,et al.Comparison of postoperative pain and recovery of erector spinae plane block and paravertebral block for patients undergoing video-assisted thoracoscopic surgery[J].同济大学学报(医学版),2020,41(2):216-220.   [点击复制]
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超声引导下竖脊肌平面阻滞和椎旁神经阻滞对VATS患者术后镇痛和恢复影响的比较
金杨,江雪梅,孙梦,温宗梅
0
(同济大学附属上海市肺科医院麻醉科,上海200433)
摘要:
目的比较超声引导下竖脊肌平面阻滞和椎旁神经阻滞对VATS患者术后镇痛和恢复的影响。方法纳入拟择期进行VATS的患者80例,年龄18~80岁,ASA分级Ⅰ~Ⅱ级,体重≥40kg。患者被随机分配到竖脊肌平面阻滞组(ESPB组,n=40)和椎旁神经阻滞组(PVB组,n=40),分别使用30、20mL 0.375%罗哌卡因进行阻滞。主要观察指标是术后第1天的40项恢复量表(QoR-40)评分,次要观察指标是术后1、6和12h的NRS疼痛评分。同时记录患者术中舒芬太尼的使用量、术后并发症的发生情况以及患者满意度。结果ESPB组和PVB组术后第1天的QoR-40量表评分(P=0.829)及术后1、6和12h的NRS疼痛评分差异均无统计学意义(P=0.0655、P=0.423、P=0.426)。两组患者术中舒芬太尼的使用量和术后并发症的发生情况也均无明显差异。ESPB组的患者满意度更高(P=0.0033)。结论超声引导下竖脊肌平面阻滞在加快VATS患者康复和术后镇痛方面与椎旁神经阻滞效果相当。竖脊肌平面阻滞可以作为一种新型的区域神经阻滞技术广泛应用于临床。
关键词:  竖脊肌平面阻滞  椎旁神经阻滞  电视辅助胸腔镜手术  术后恢复
DOI:10.16118/j.1008-0392.2020.02.013
投稿时间:2019-08-05
基金项目:上海市自然科学基金(19ZR1443000);同济大学附属上海市肺科医院麻醉科学科发展基金2019;同济大学附属上海市肺科医院创新群体基金(fkcx1906)
Comparison of postoperative pain and recovery of erector spinae plane block and paravertebral block for patients undergoing video-assisted thoracoscopic surgery
JIN Yang,JIANG Xue-mei,SUN Meng,WEN Zong-mei
(Dept. of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China)
Abstract:
ObjectiveTo compare postoperative outcomes of erector spinae plane block(ESPB) and paravertebral block(PVB) in patients undergoing video-assisted thoracoscopic surgery(VATS). MethodsEighty ASA Ⅰ-Ⅱ patients, aged 18-80 years and weighted >40kg, scheduled for elective VATS were enrolled in this study. Patients were randomly assigned into two groups with 40 cases in each group:ESPB group received ultrasound-guided erector spinae plane block with 30mL of 0.375% ropivacaine and PVB group received ultrasound-guided paravertebral block with 20mL of 0.375% ropivacaine. The primary outcome was evaluated with Quality of Recovery-40(QoR-40) score on postoperative day 1(POD1). The secondary outcome was NRS pain score during the first 12 hours. Other outcomes included intraoperative sufentanil consumption, postoperative complications and patient satisfaction. ResultsNo significant differences were found in these two groups for global QoR-40 scores on POD1(P=0.829), or the NRS pain scores at postoperative 1, 6 and 12h(P=0.0655, P=0.423 and P=0.426, respectively), as well as intraoperative sufentanil consumption and postoperative complications. Patient satisfaction was better in ESPB group compared to PVB group(8.3±1.3 vs 7.4 ±1.4, P=0.0033). ConclusionThis study showed that ultrasound-guided ESPB is an effective regional block technique comparable to PVB in improving rapid recovery and reducing postoperative pain for patients undergoing VATS, indicating that ESPB may serve as a substitute of PVB for rapid recovery and postoperative pain control.
Key words:  erector spinae plane block  paravertebral block  video-assisted thoracoscopic surgery  quality of recovery

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