■超声引导的竖脊肌平面阻滞(ESPB)已成为控制术后疼痛的有效方法,并且可能是硬膜外阻滞的良好替代方法。然而,关于ESPB局部麻醉药合适浓度的相关研究仍然很少。
■本研究旨在探讨接受电视胸腔镜手术(VATS)的患者中ESPB的最佳罗哌卡因浓度。
■共纳入68例接受VATS肺叶切除术的患者。使用三种不同浓度的罗哌卡因作为局部麻醉剂进行同侧超声引导的ESPB:0.189%(G1),0.375%(G2),和0.556%(G3)。围手术期给予瑞芬太尼的总量,应用患者自控镇痛(PCA),获得术后24h镇痛的抢救药物,并获得数字评定量表(NRS)评分。
■术中瑞芬太尼给药总量为7.20±3.04mcg/kg,5.32±2.70mcg/kg,G1、G2和G3组4.60±1.75,分别。G2和G3的瑞芬太尼给药量明显低于G1组(P=0.02vs.G2;P=0.003vs.G3).在围手术期,G3组比G1和G2组需要更多的肌力增强剂(P=0.045)。NRS评分,PCA,和抢救药物在三组中没有显着差异。
■推荐用于ESPB的罗哌卡因的最佳浓度为0.375%,这是在控制疼痛和减少术中阿片类药物的需求和最小的不良反应,如低血压是有效的。
UNASSIGNED: An ultrasound-guided erector spinae plane block (ESPB) has emerged as an effective way to control postoperative pain and may be a good alternative way to an epidural block. However, relevant research on the appropriate concentration of local anesthetics for an ESPB remains scarce.
UNASSIGNED: This study aimed to investigate the optimal concentration of ropivacaine for an ESPB in patients undergoing video-assisted thoracoscopic surgery (VATS).
UNASSIGNED: A total of 68 patients who underwent a VATS lobectomy were enrolled. An ipsilateral ultrasound-guided ESPB was performed with three different ropivacaine concentrations as a local anesthetic: 0.189% (G1), 0.375% (G2), and 0.556% (G3). The total amount of perioperative remifentanil administered, patient-controlled analgesia (PCA) applied, and rescue drugs for postoperative analgesia during the 24 h after surgery were acquired, and numeric rating scale (NRS) scores were obtained.
UNASSIGNED: The total amount of intraoperative remifentanil administered was 7.20 ± 3.04 mcg/kg, 5.32 ± 2.70 mcg/kg, and 4.60 ± 1.75 in the G1, G2, and G3 groups, respectively. G2 and G3 had significantly lower amounts of remifentanil administered than the G1 group (P = 0.02 vs. G2; P = 0.003 vs. G3). The G3 group needed more inotropes than the G1 and G2 groups in the perioperative period (P = 0.045). The NRS scores, PCA, and rescue drug were not significantly different in the three groups.
UNASSIGNED: The optimal concentration of ropivacaine recommended for an ESPB was 0.375%, which was effective in controlling pain and reducing the intraoperative opioid requirements with minimal adverse reactions such as hypotension.