PDF(Pubmed)
Abstract：
Erector spinae plane block is a promising strategy for pain management in some settings. However, the effectiveness of erector spinae plane block versus caudal block in pediatric inguinal hernia repair has yet to be formally investigated.
One hundred and two patients aged 2-5 years undergoing unilateral open inguinal hernia repair randomly received unilateral erector spinae plane block (0.2% ropivacaine 0.5 mL kg-1), caudal block (0.2% ropivacaine 1 mL kg-1), or no block. The primary outcome was time to the first rescue analgesia, defined as the interval from the end of surgery to the Face, Legs, Activity, Cry, and Consolability scale greater than three. Secondary outcomes included the number of patients requiring rescue analgesia, the area under the curve of pain scores over time, satisfaction of guardians, and adverse events.
The median time to the first rescue analgesia was longer in the erector spinae plane block group than in the caudal block group [10.0 h (interquartile range, 6.6-24.0 h) vs. 5.0 h (interquartile range, 2.9-7.3 h); p < .001]. The Cox regression model demonstrated that the risk of postoperative rescue analgesia requirement was 0.38 in children receiving erector spinae plane block compared with caudal block (95% confidence interval 0.23-0.64; p < .001). Additionally, the area under the curve of the pain scores over time was lower in the erector spinae plane block group than in the caudal block group (44.3 [36.6-50.7] vs. 59.0 [47.1-64.5]; p < .001).
Erector spinae plane block provided superior postoperative analgesia compared to caudal block in children undergoing inguinal hernia repair.Trial registration: Chinese Clinical Trial Registry; ChiCTR2100048303.
Erector spinae plane block (ESPB) is beneficial for postoperative analgesia in children undergoing inguinal hernia repair.Ultrasound-guided ESPB provided superior analgesia efficacy to caudal block in the pediatric population.ESPB is an attractive strategy for pain management after lower abdominal surgical procedures.
One hundred and two patients aged 2-5 years undergoing unilateral open inguinal hernia repair randomly received unilateral erector spinae plane block (0.2% ropivacaine 0.5 mL kg-1), caudal block (0.2% ropivacaine 1 mL kg-1), or no block. The primary outcome was time to the first rescue analgesia, defined as the interval from the end of surgery to the Face, Legs, Activity, Cry, and Consolability scale greater than three. Secondary outcomes included the number of patients requiring rescue analgesia, the area under the curve of pain scores over time, satisfaction of guardians, and adverse events.
The median time to the first rescue analgesia was longer in the erector spinae plane block group than in the caudal block group [10.0 h (interquartile range, 6.6-24.0 h) vs. 5.0 h (interquartile range, 2.9-7.3 h); p < .001]. The Cox regression model demonstrated that the risk of postoperative rescue analgesia requirement was 0.38 in children receiving erector spinae plane block compared with caudal block (95% confidence interval 0.23-0.64; p < .001). Additionally, the area under the curve of the pain scores over time was lower in the erector spinae plane block group than in the caudal block group (44.3 [36.6-50.7] vs. 59.0 [47.1-64.5]; p < .001).
Erector spinae plane block provided superior postoperative analgesia compared to caudal block in children undergoing inguinal hernia repair.Trial registration: Chinese Clinical Trial Registry; ChiCTR2100048303.
Erector spinae plane block (ESPB) is beneficial for postoperative analgesia in children undergoing inguinal hernia repair.Ultrasound-guided ESPB provided superior analgesia efficacy to caudal block in the pediatric population.ESPB is an attractive strategy for pain management after lower abdominal surgical procedures.
摘要：
■在某些情况下，Erectorspinae平面阻滞是一种有前途的疼痛管理策略。然而,竖脊肌平面阻滞与尾肌阻滞在小儿腹股沟疝修补术中的有效性尚待正式研究。
■接受单侧开放式腹股沟疝修补术的2-5岁患者随机接受单侧竖脊肌平面阻滞（0.2％罗哌卡因0.5mLkg-1），尾阻滞（0.2％罗哌卡因1mLkg-1），或者没有街区。主要结局是首次抢救镇痛的时间，定义为从手术结束到面部的间隔，腿,活动,哭吧,和可协性等级大于三。次要结局包括需要抢救镇痛的患者人数，随着时间的推移，疼痛评分曲线下的面积，监护人的满意度，和不良事件。
■竖脊肌平面阻滞组的首次抢救镇痛的中位时间长于尾神经阻滞组[10.0h（四分位距，6.6-24.0h)vs.5.0h(四分位数间距，2.9-7.3小时)；p<.001]。Cox回归模型表明，与尾肌阻滞相比，使用竖脊肌平面阻滞的儿童术后镇痛要求的风险为0.38（95％置信区间0.23-0.64；p<.001）。此外,随着时间的推移，竖脊肌平面阻滞组的疼痛评分曲线下面积低于尾部阻滞组（44.3[36.6-50.7]vs.59.0[47.1-64.5]；p<.001)。
■在接受腹股沟疝修补术的儿童中，与尾部阻滞相比，Erectorspinae平面阻滞提供了更好的术后镇痛效果。试验注册：中国临床试验注册中心；ChiCTR2100048303。
腹肌平面阻滞（ESPB）有利于腹股沟疝修补术患儿术后镇痛。超声引导下的ESPB在小儿人群中提供了优于尾部阻滞的镇痛效果。ESPB是下腹部外科手术后疼痛管理的有吸引力的策略。
■接受单侧开放式腹股沟疝修补术的2-5岁患者随机接受单侧竖脊肌平面阻滞（0.2％罗哌卡因0.5mLkg-1），尾阻滞（0.2％罗哌卡因1mLkg-1），或者没有街区。主要结局是首次抢救镇痛的时间，定义为从手术结束到面部的间隔，腿,活动,哭吧,和可协性等级大于三。次要结局包括需要抢救镇痛的患者人数，随着时间的推移，疼痛评分曲线下的面积，监护人的满意度，和不良事件。
■竖脊肌平面阻滞组的首次抢救镇痛的中位时间长于尾神经阻滞组[10.0h（四分位距，6.6-24.0h)vs.5.0h(四分位数间距，2.9-7.3小时)；p<.001]。Cox回归模型表明，与尾肌阻滞相比，使用竖脊肌平面阻滞的儿童术后镇痛要求的风险为0.38（95％置信区间0.23-0.64；p<.001）。此外,随着时间的推移，竖脊肌平面阻滞组的疼痛评分曲线下面积低于尾部阻滞组（44.3[36.6-50.7]vs.59.0[47.1-64.5]；p<.001)。
■在接受腹股沟疝修补术的儿童中，与尾部阻滞相比，Erectorspinae平面阻滞提供了更好的术后镇痛效果。试验注册：中国临床试验注册中心；ChiCTR2100048303。
腹肌平面阻滞（ESPB）有利于腹股沟疝修补术患儿术后镇痛。超声引导下的ESPB在小儿人群中提供了优于尾部阻滞的镇痛效果。ESPB是下腹部外科手术后疼痛管理的有吸引力的策略。
