PDF(Pubmed)
Abstract：
UNASSIGNED: Pediatric patients often experience severe pain after thoracic surgery, especially in the early postoperative period. Recently, the focus has been on regional analgesia with the introduction of ultrasound-guided erector spinae plane blocks. We assumed that preoperative erector spinae plane block (ESPB) in children undergoing video-assisted thoracoscopic surgery (VATS) would reduce the consumption of perioperative opioids.
UNASSIGNED: This randomized, double-blind study enrolled 60 children aged 1-3 years who underwent thoracoscopic lung lesion resection. The patients were enrolled in the study and randomly divided into two groups. The general anesthesia (GA) group received GA alone, and the GA + ESPB group received ESPB. The consumptions of remifentanil and sufentanil were recorded, and the children\'s face, legs, activity, cry, consolability (FLACC) scores were assessed after awakening. The time to first rescue analgesia, length of hospital stay, parental satisfaction and adverse events were also recorded.
UNASSIGNED: The consumptions of remifentanil and sufentanil in the GA + ESPB group were significantly lower than those in the GA group, mean difference [95% confidence interval (CI)]: -26.57 (-31.98 to -21.17) and -0.21 (-0.27 to -0.17), respectively, (both P<0.001); while the time to first rescue analgesia and parental satisfaction scores were significantly longer and higher, respectively, in the GA + ESPB group than those in the GA group, mean difference (95% CI): 2.37 (1.77 to 2.97) and 2.47 (1.79 to 3.15), respectively, (both P<0.001). The FLACC scores in the GA + ESPB group were significantly lower than those in the GA group 1 to 24 hours postoperatively (P=0.023 at 1 h, and P<0.001 at 3 h, 6 h, 12 h, 18 h, 24 h), but not at immediate admission to the post-anesthesia care unit (PACU) (P=0.189 at 0 h). The GA + ESPB group had significantly lower incidence rates of postoperative nausea and vomiting (P=0.037 and P=0.020).
UNASSIGNED: In pediatric Thoracoscopic surgery, the results of this study confirm our hypothesis that ESPB decreases the consumptions of intraoperative remifentanil and postoperative sufentanil in 24 hours and demonstrates better postoperative analgesia compared with a control group.
UNASSIGNED: Chinese Clinical Trial Registry ChiCTR2200056166.
UNASSIGNED: This randomized, double-blind study enrolled 60 children aged 1-3 years who underwent thoracoscopic lung lesion resection. The patients were enrolled in the study and randomly divided into two groups. The general anesthesia (GA) group received GA alone, and the GA + ESPB group received ESPB. The consumptions of remifentanil and sufentanil were recorded, and the children\'s face, legs, activity, cry, consolability (FLACC) scores were assessed after awakening. The time to first rescue analgesia, length of hospital stay, parental satisfaction and adverse events were also recorded.
UNASSIGNED: The consumptions of remifentanil and sufentanil in the GA + ESPB group were significantly lower than those in the GA group, mean difference [95% confidence interval (CI)]: -26.57 (-31.98 to -21.17) and -0.21 (-0.27 to -0.17), respectively, (both P<0.001); while the time to first rescue analgesia and parental satisfaction scores were significantly longer and higher, respectively, in the GA + ESPB group than those in the GA group, mean difference (95% CI): 2.37 (1.77 to 2.97) and 2.47 (1.79 to 3.15), respectively, (both P<0.001). The FLACC scores in the GA + ESPB group were significantly lower than those in the GA group 1 to 24 hours postoperatively (P=0.023 at 1 h, and P<0.001 at 3 h, 6 h, 12 h, 18 h, 24 h), but not at immediate admission to the post-anesthesia care unit (PACU) (P=0.189 at 0 h). The GA + ESPB group had significantly lower incidence rates of postoperative nausea and vomiting (P=0.037 and P=0.020).
UNASSIGNED: In pediatric Thoracoscopic surgery, the results of this study confirm our hypothesis that ESPB decreases the consumptions of intraoperative remifentanil and postoperative sufentanil in 24 hours and demonstrates better postoperative analgesia compared with a control group.
UNASSIGNED: Chinese Clinical Trial Registry ChiCTR2200056166.
摘要：
■儿科患者在开胸手术后经常会出现剧烈疼痛，尤其是在术后早期。最近,通过引入超声引导下的竖脊肌平面阻滞，重点是区域镇痛。我们假设接受电视胸腔镜手术（VATS）的儿童术前勃起脊髓平面阻滞（ESPB）可以减少围手术期阿片类药物的消耗。
■这是随机的，双盲研究纳入了60名1~3岁接受胸腔镜肺病灶切除术的儿童.将患者纳入研究并随机分为两组。全身麻醉（GA）组单独接受GA，GA+ESPB组接受ESPB。记录瑞芬太尼和舒芬太尼的用量,和孩子们的脸，腿,活动,哭泣，苏醒后评估可控制性（FLACC）评分。第一次抢救镇痛的时间，住院时间,还记录了家长满意度和不良事件.
■GA+ESPB组瑞芬太尼和舒芬太尼的消耗量明显低于GA组，平均差[95%置信区间(CI)]：-26.57(-31.98至-21.17)和-0.21(-0.27至-0.17)，分别,(均P<0.001);而首次抢救镇痛时间和家长满意度评分明显延长,分别,GA+ESPB组比GA组,平均差（95%CI）：2.37（1.77至2.97）和2.47（1.79至3.15），分别,（均P<0.001）。术后1~24小时,GA+ESPB组的FLACC评分明显低于GA组(P=0.023,3h时P<0.001，6h,12h,18h,24h),但不是立即进入麻醉后监护病房（PACU）（0h时P=0.189）。GA+ESPB组术后恶心呕吐发生率显著降低(P=0.037和P=0.020)。
■在小儿胸腔镜手术中，本研究结果证实了我们的假设,即与对照组相比,ESPB降低了术中瑞芬太尼和术后24小时舒芬太尼的消耗量,并显示出更好的术后镇痛效果.
■中国临床试验注册中心ChiCTR2200056166。
■这是随机的，双盲研究纳入了60名1~3岁接受胸腔镜肺病灶切除术的儿童.将患者纳入研究并随机分为两组。全身麻醉（GA）组单独接受GA，GA+ESPB组接受ESPB。记录瑞芬太尼和舒芬太尼的用量,和孩子们的脸，腿,活动,哭泣，苏醒后评估可控制性（FLACC）评分。第一次抢救镇痛的时间，住院时间,还记录了家长满意度和不良事件.
■GA+ESPB组瑞芬太尼和舒芬太尼的消耗量明显低于GA组，平均差[95%置信区间(CI)]：-26.57(-31.98至-21.17)和-0.21(-0.27至-0.17)，分别,(均P<0.001);而首次抢救镇痛时间和家长满意度评分明显延长,分别,GA+ESPB组比GA组,平均差（95%CI）：2.37（1.77至2.97）和2.47（1.79至3.15），分别,（均P<0.001）。术后1~24小时,GA+ESPB组的FLACC评分明显低于GA组(P=0.023,3h时P<0.001，6h,12h,18h,24h),但不是立即进入麻醉后监护病房（PACU）（0h时P=0.189）。GA+ESPB组术后恶心呕吐发生率显著降低(P=0.037和P=0.020)。
■在小儿胸腔镜手术中，本研究结果证实了我们的假设,即与对照组相比,ESPB降低了术中瑞芬太尼和术后24小时舒芬太尼的消耗量,并显示出更好的术后镇痛效果.
■中国临床试验注册中心ChiCTR2200056166。
