PDF(Pubmed)
Abstract：
BACKGROUND: Conventional fascial plane block approaches for upper abdominal surgeries spare the lateral cutaneous nerve. An external oblique intercostal block (EOIB) may be suitable for upper abdominal incisions as it blocks the lateral and anterior branches of the intercostal nerves T6-T10. However, there is a paucity of studies evaluating this block in clinical settings. The study aimed to compare the analgesic efficacy of combined EOIB and rectus sheath block with local infiltration analgesia (LIA) in laparoscopic cholecystectomy (LC).
METHODS: After obtaining written informed consent, 70 patients were randomly allocated to undergo right-sided EOIB with 20 ml and left-sided RSB with 10 ml of 0.25% bupivacaine at the end of surgery (group ER, n = 35). Patients in the LIA group (n = 35) underwent local infiltration at the port site using 20 ml of the same solution (group LIA, n=35).
RESULTS: The visual analog scale scores with combined EOI and RSB were significantly lower than those with LIA at 1, 2, 4, 8, and 12 h (P < 0.001). Rescue analgesics were required by 65.7% and 14.3% of the patients in the LIA and block groups, respectively (P < 0.001). The time to first rescue analgesic was significantly greater in the ER group than that in the LIA group (2.8 ± 1.10 vs. 1.6 ± 0.50 h; P = 0.012). The number of times rescue analgesia was required was significantly lower in the ER group than that in the LIA group (1.00 ± 0.00 vs. 1.83 ± 0.72; P = 0.015). Nausea and vomiting scores were higher in the LIA group than those in the ER group (P < 0.001). Patient satisfaction scores were higher in the ER group than those in the LIA group.
CONCLUSIONS: EOIB combined with RSB provides superior analgesia compared with LIA and should be considered for LC.
METHODS: After obtaining written informed consent, 70 patients were randomly allocated to undergo right-sided EOIB with 20 ml and left-sided RSB with 10 ml of 0.25% bupivacaine at the end of surgery (group ER, n = 35). Patients in the LIA group (n = 35) underwent local infiltration at the port site using 20 ml of the same solution (group LIA, n=35).
RESULTS: The visual analog scale scores with combined EOI and RSB were significantly lower than those with LIA at 1, 2, 4, 8, and 12 h (P < 0.001). Rescue analgesics were required by 65.7% and 14.3% of the patients in the LIA and block groups, respectively (P < 0.001). The time to first rescue analgesic was significantly greater in the ER group than that in the LIA group (2.8 ± 1.10 vs. 1.6 ± 0.50 h; P = 0.012). The number of times rescue analgesia was required was significantly lower in the ER group than that in the LIA group (1.00 ± 0.00 vs. 1.83 ± 0.72; P = 0.015). Nausea and vomiting scores were higher in the LIA group than those in the ER group (P < 0.001). Patient satisfaction scores were higher in the ER group than those in the LIA group.
CONCLUSIONS: EOIB combined with RSB provides superior analgesia compared with LIA and should be considered for LC.
摘要：
背景：用于上腹部手术的传统筋膜平面阻滞方法保留了外侧皮神经。外斜肋间阻滞（EOIB）可能适用于上腹部切口，因为它阻塞了肋间神经T6-T10的外侧和前分支。然而,在临床环境中评估这种阻滞的研究很少.本研究旨在比较EOIB联合直肌鞘阻滞与局部浸润镇痛(LIA)在腹腔镜胆囊切除术(LC)中的镇痛效果。
方法：在获得书面知情同意书后，70例患者随机分配在手术结束时接受20ml的右侧EOIB和10ml的0.25％布比卡因的左侧RSB（ER组，n=35)。LIA组患者（n=35）使用20ml相同的溶液在港口部位进行局部浸润（LIA组，n=35)。
结果：EOI和RSB组合的视觉模拟量表评分在1、2、4、8和12h均显着低于LIA（P<0.001）。LIA和阻滞组中65.7%和14.3%的患者需要抢救镇痛药，分别(P<0.001)。ER组首次抢救镇痛时间明显长于LIA组（2.8±1.10vs.1.6±0.50h;P=0.012)。与LIA组相比，ER组需要进行抢救镇痛的次数明显减少（1.00±0.00vs.1.83±0.72；P=0.015）。LIA组恶心呕吐评分高于ER组(P<0.001)。ER组患者满意度评分高于LIA组。
结论：EOIB联合RSB与LIA相比具有更好的镇痛效果，应考虑用于LC。
方法：在获得书面知情同意书后，70例患者随机分配在手术结束时接受20ml的右侧EOIB和10ml的0.25％布比卡因的左侧RSB（ER组，n=35)。LIA组患者（n=35）使用20ml相同的溶液在港口部位进行局部浸润（LIA组，n=35)。
结果：EOI和RSB组合的视觉模拟量表评分在1、2、4、8和12h均显着低于LIA（P<0.001）。LIA和阻滞组中65.7%和14.3%的患者需要抢救镇痛药，分别(P<0.001)。ER组首次抢救镇痛时间明显长于LIA组（2.8±1.10vs.1.6±0.50h;P=0.012)。与LIA组相比，ER组需要进行抢救镇痛的次数明显减少（1.00±0.00vs.1.83±0.72；P=0.015）。LIA组恶心呕吐评分高于ER组(P<0.001)。ER组患者满意度评分高于LIA组。
结论：EOIB联合RSB与LIA相比具有更好的镇痛效果，应考虑用于LC。
