OBJECTIVE: To compare the relative efficacy of ultrasound-guided ESPB and CEB for postoperative analgesia after a single-level lumbar fusion surgery and compared it with conventional multimodal analgesia.
METHODS: 81 patients requiring single-level lumbar fusion surgery were randomly allocated into 3 groups (ESPB group, CEB group, and the control group). Demographic and surgical data (blood loss, duration of surgery, perioperative total opioid consumption, muscle relaxants used) were assessed. Postoperatively, the surgical site pain, alertness scale, satisfaction score, time to mobilization, and complications were recorded.
RESULTS: The total opioid consumption in the first 24 hours was significantly lower in both the block groups than in the control group (103.70 ± 13.34 vs 105 ± 16.01 vs 142.59 ± 40.91mcg; P < .001). The total muscle relaxant consumption was also significantly less in block groups compared to controls (50.93 ± 1.98 vs 52.04 ± 3.47 vs 55.00 ± 5.29 mg; P < .001). The intraoperative blood loss was significantly less in both the block group (327.78 ± 40.03 mL, 380.74 ± 77.80 mL) than the control group (498.89 ± 71.22 mL) (P < .001). Among the block groups, the immediate postoperative pain relief was better in the CEB group, however, the ESPB group had a longer duration of postoperative pain relief.
CONCLUSIONS: Both ESPB and CEB produce adequate postoperative analgesia after lumbar fusion however the duration of action was significantly longer in the ESPB group with relatively shorter surgical time and lesser blood loss compared to the CEB group.
目的:比较超声引导下ESPB和CEB用于单节段腰椎融合术后镇痛的相对疗效,并与常规多模式镇痛进行比较。
方法:81例需要单级腰椎融合手术的患者随机分为3组(ESPB组,行政首长协调会小组,和对照组)。人口统计学和手术数据(失血,手术持续时间,围手术期阿片类药物总消费量,使用的肌肉松弛剂)进行评估。术后,手术部位疼痛,警觉性量表,满意度得分,动员时间,并记录并发症。
结果:两个阻滞组的前24小时阿片类药物总消耗量均显着低于对照组(103.70±13.34vs105±16.01vs142.59±40.91mcg;P<.001)。与对照组相比,阻滞组的总肌肉松弛剂消耗量也显着减少(50.93±1.98vs52.04±3.47vs55.00±5.29mg;P<.001)。两组患者术中出血量均明显减少(327.78±40.03mL,380.74±77.80mL)高于对照组(498.89±71.22mL)(P<.001)。在区块组中,CEB组术后即刻疼痛缓解较好,然而,ESPB组术后疼痛缓解持续时间较长.
结论:ESPB和CEB在腰椎融合术后都能产生足够的术后镇痛效果,但与CEB组相比,ESPB组的作用持续时间明显更长,手术时间相对更短,失血更少。