OBJECTIVE: To assess the safety and efficacy of an ultrasound-guided ISP block for postoperative analgesia in posterior cervical laminectomy.
METHODS: 88 patients requiring posterior cervical laminectomy were randomized into two groups, those who underwent ISP block with multimodal analgesia (ISPB group) and those with only multimodal analgesia (control group). Demographic details, intraoperative parameters (blood loss, duration of surgery, perioperative total opioid consumption, muscle relaxants used), and postoperative parameters (numeric rating scale, satisfaction score, mobilization time, and complications) were recorded.
RESULTS: The total opioid consumption (128.41 + 39.65vs 284.09 + 140.92mcg; P < .001), muscle relaxant usage (46.14 + 6.18 mg vs 59.32 + 3.97 mg; P < .001), surgical duration (128.61 + 26.08/160.23 + 30.99mins; P < .01), and intra-operative blood loss (233.18 + 66.08 mL vs 409.77 + 115.41 mL; P < .01) were significantly less in the ISPB group compared to the control. In the postoperative period, the control group\'s pain score was significantly higher (P < .001) in the initial 48 hours. The Modified Observer Alertness/Sedation Score (MOASS) score and satisfaction scores were significantly better in the ISPB compared to the control (P < .001). The mean time required to ambulate was statistically less in ISPB (4.30 + 1.64hours) when compared to controls (9.48 + 3.07hours) (P < .001).
CONCLUSIONS: In patients undergoing posterior cervical laminectomy, ISP block is a safe and effective technique with better outcomes than standard multi-modal analgesia alone, in terms of reduced intra-operative opioid requirements and blood loss, better postoperative analgesia, and early mobilization.
目的:评估超声引导下ISP阻滞用于颈椎后路椎板切除术术后镇痛的安全性和有效性。
方法:88例需要颈椎后路椎板切除术的患者随机分为两组,接受ISP阻滞的患者(ISPB组)和仅接受多模式镇痛的患者(对照组).人口统计细节,术中参数(失血,手术持续时间,围手术期阿片类药物总消费量,使用肌肉松弛剂),和术后参数(数字评定量表,满意度得分,动员时间,和并发症)记录。
结果:阿片类药物总消费量(128.4139.65vs284.09140.92mcg;P<.001),肌肉松弛剂用量(46.14+6.18mgvs59.32+3.97mg;P<.001),手术时间(128.61+26.08/160.23+30.99分钟;P<.01),术中失血量(233.18+66.08mLvs409.77+115.41mL;P<.01)显著低于对照组。在术后期间,在最初的48小时,对照组的疼痛评分显著高于(P<.001)。与对照组相比,ISPB的改良观察者警觉/镇静评分(MOASS)评分和满意度评分明显更好(P<.001)。与对照组(9.483.07小时)相比,ISPB(4.301.64小时)所需的平均步行时间在统计学上较少(P<.001)。
结论:在接受颈椎后路椎板切除术的患者中,ISP阻滞是一种安全有效的技术,与标准的多模式镇痛相比,效果更好。在减少术中阿片类药物需求和失血方面,更好的术后镇痛,早期动员。