PDF(Pubmed)
Abstract：
UNASSIGNED: With the advancements in regional anesthesia and ultrasound techniques, the use of non-neuraxial blocks like the erector spinae plane block (ESPB) has been increasing in cardiac surgeries with promising outcomes. A total of 3,264 articles were identified through a literature search. Intervention was defined as ESPB. Comparators were no regional technique performed or sham blocks. Four studies with a total of 226 patients were included. Postoperative opioid consumption was lower in the group that received ESPB than the group that did not (weighted mean difference [WMD]: -204.08; 95% CI: -239.98 to -168.19; P < 0.00001). Intraoperative opioid consumption did not differ between the two groups (WMD: -398.14; 95% CI: -812.17 to 15.98; P = 0.06). Pain scores at 0 hours were lower in the group that received ESPB than the group that did not (WMD: -1.27; 95% CI: -1.99 to -0.56; P = 0.0005). Pain scores did not differ between the two groups at 4-6 hours (WMD: -0.79; 95% CI: -1.70 to 0.13; P = 0.09) and 12 hours (WMD: -0.83; 95% CI: -1.82 to 0.16; P = 0.10). Duration of mechanical ventilation in minutes was lower in the group that received ESPB than the group that did not (WMD: -45.12; 95% CI: -68.82 to -21.43; P = 0.0002). Given the limited number of studies and the substantial heterogeneity of measured outcomes and interventions, further studies are required to assess the benefit of ESPB in midline sternotomies.
摘要：
■随着区域麻醉和超声技术的进步，在心脏手术中,像竖脊肌平面阻滞(ESPB)这样的非神经轴阻滞的使用一直在增加,结果有希望.通过文献检索，共确定了3,264篇文章。干预被定义为ESPB。比较物是没有进行区域技术或假区块。共纳入四项研究，共226名患者。接受ESPB组的术后阿片类药物消耗量低于未接受ESPB组（加权平均差[WMD]：-204.08；95％CI：-239.98至-168.19；P<0.00001）。两组患者术中阿片类药物用量无差异（WMD：-398.14；95%CI：-812.17至15.98；P=0.06）。接受ESPB组0小时疼痛评分低于未接受ESPB组(WMD:-1.27;95%CI:-1.99至-0.56;P=0.0005)。在4-6小时（WMD：-0.79;95％CI：-1.70至0.13;P=0.09）和12小时（WMD：-0.83;95％CI：-1.82至0.16;P=0.10），两组之间的疼痛评分没有差异。接受ESPB组的机械通气持续时间(分钟)低于未接受ESPB组(WMD:-45.12;95%CI:-68.82至-21.43;P=0.0002)。鉴于研究数量有限以及测量结果和干预措施的巨大异质性，需要进一步的研究来评估ESPB在中线胸骨切开术中的获益.
