PDF(Pubmed)
Abstract：
Erector spinae plane block is a recently introduced block with a wide range of indications. The aim of the present study was to assess the efficacy and safety of ultrasound-guided erector spinae plane block on early post-operative pain relief in patients undergoing modified radical mastectomy. We conducted a prospective, randomized, controlled study in a tertiary care institute. Sixty-five patients were enrolled. Final analysis was performed on 58 patients randomized into two groups. Ultrasound-guided erector spinae plane block with 25 mL of 0.25% bupivacaine was given using a 18 gauge needle. No block was given in the other group. All patients received general anesthesia. Primary outcome measure was 24-hour analgesic consumption. Secondary outcome measures included intra-operative fentanyl consumption, time to first analgesic request, Visual Analog Scale score, nausea score, sedation score, wound quality and patient satisfaction score. Post-operative additional analgesics and intra-operative fentanyl were significantly reduced in patients receiving erector spinae plane block. Time to rescue analgesia was significantly delayed. Visual Analog Scale score was significantly lower at all time intervals. Post-operative nausea at various time intervals was also less. Patient satisfaction score was also noted on a 5-point scale and there was a statistical significant difference. We concluded that erector spinae plane block is a safe technique and provides good analgesia in breast surgery.
摘要：
Erectorspinae平面阻滞是最近引入的具有广泛适应症的阻滞。本研究的目的是评估超声引导下的竖脊肌平面阻滞对接受改良根治术的患者术后早期疼痛缓解的有效性和安全性。我们进行了一个前瞻性的，随机化，在一个三级护理机构的对照研究。纳入65例患者。对58例患者进行最终分析，随机分为两组。使用18号针头给予25mL0.25％布比卡因的超声引导下的竖脊肌平面阻滞。另一组未给予阻断。所有患者均接受全身麻醉。主要结果指标为24小时镇痛消耗量。次要结果指标包括术中芬太尼消耗量，第一次镇痛请求的时间，视觉模拟量表评分,恶心评分,镇静评分,伤口质量和患者满意度评分。在接受竖脊肌平面阻滞的患者中，术后额外的镇痛药和术中芬太尼显着减少。抢救镇痛时间明显延迟。视觉模拟量表评分在所有时间间隔均显着较低。不同时间间隔的术后恶心也较少。患者满意度评分也以5分制记录，差异有统计学意义。我们的结论是，竖脊肌平面阻滞是一种安全的技术，并在乳腺手术中提供了良好的镇痛效果。
