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Abstract：
Introduction This prospective, randomized controlled study aimed to investigate the efficacy and respiratory effects of postoperative pain management with an erector spinae plane block in patients undergoing percutaneous nephrolithotomy. Methods Sixty American Society of Anesthesiologists (ASA) I-II patients aged 18-65 years, scheduled to undergo percutaneous nephrolithotomy, were randomized either to the erector spinae plane block (ESPB) or control group. Fifteen mL 0.5% bupivacaine at the T11 level was administered preoperatively using the in-plane technique in the ESPB group. In both groups, 1 gr of intravenous paracetamol was administered intraoperatively. Postoperative pain and agitation were evaluated using the visual analog scale (VAS), dynamic VAS at zero, six, and 24 hours, and the Riker sedation-agitation scale at the 0th hour after surgery. Peak expiratory flow rate (PEFR) and oxygen saturation (SpO2) were measured in preoperative examination and at the 0th, 6th, and 24th hours postoperatively. The time and number of the analgesic requirement, mobilization, and discharge time were also recorded. Results A significantly lower VAS and dynamic VAS were observed at the 0th, 6th, and 24th hours in the ESPB group (p<0.05 for each timepoint). The postoperative/preoperative PEFR ratio was lower and there were more agitated patients in the control group (p<0.05). Conclusion An erector spinae plane block may have additional clinical advantages while providing effective analgesia in patients who underwent percutaneous nephrolithotomy compared to intravenous analgesia.
摘要：
引言这个前瞻性的，随机对照研究旨在探讨经皮肾镜取石术患者术后疼痛治疗的疗效和呼吸影响。方法60例美国麻醉医师协会(ASA)Ⅰ～Ⅱ级患者,年龄18～65岁,计划接受经皮肾镜取石术，随机分为竖脊肌平面阻滞（ESPB）组或对照组。在ESPB组中，术前使用平面内技术给予T11水平的15mL0.5％布比卡因。在这两组中,术中静脉注射1克扑热息痛。术后疼痛和躁动使用视觉模拟量表（VAS）进行评估，动态VAS为零，六,24小时,和手术后第0小时的Riker镇静-激动量表。术前检查和第0次测量峰值呼气流速(PEFR)和氧饱和度(SpO2),6th,术后24小时。需要镇痛的时间和次数，动员,并记录放电时间。结果0时观察到明显较低的VAS和动态VAS,6th,ESPB组的第24小时和第24小时（每个时间点p<0.05）。对照组术后/术前PEFR比值较低，躁动患者较多（p<0.05）。结论与静脉镇痛相比，在经皮肾镜取石术患者中，竖脊肌平面阻滞在提供有效镇痛的同时可能具有额外的临床优势。
