背景:本研究旨在评估腹腔镜胆囊切除术中单侧肋间斜神经阻滞(EOIB)的有效性。
方法:伦理委员会批准后,将接受腹腔镜胆囊切除术手术的18-70岁的ASAI-II患者纳入研究。将患者分为两组,外斜肋间神经阻滞(EOIB组)和斜肋下腹横肌平面阻滞(OSTAP组)。手术后,EOIB或OSTAP阻滞与20毫升.25%布比卡因,然后常规镇痛方案应用于静脉注射扑热息痛,还有曲马多.术后24小时监测视觉模拟量表(VAS)评分和患者自控镇痛(PCA)消耗。对VAS≥4的患者给予25mg哌替啶作为抢救镇痛药。
结果:研究中纳入了EOIB组36例患者和OSTAP组34例患者。所有组均观察到较低的VAS评分。当PCA消耗时,副作用,抢救镇痛消耗,并对患者满意度进行了评估,组间差异无统计学意义(P>.05)。
结论:观察到EOIB显示与OSTAP阻滞相似的镇痛活性。通过减少LC术后阿片类药物的消耗,EOIB也可能是术后多模式镇痛的一部分。
BACKGROUND: This study aimed to evaluate the effectiveness of unilateral external oblique intercostal nerve block (EOIB) in laparoscopic cholecystectomy surgery.
METHODS: After ethics committee approval, ASA I-II patients aged 18-70 who would undergo laparoscopic cholecystectomy surgery were included in the study. The patients were divided into two groups, external oblique intercostal nerve block (Group EOIB) and oblique subcostal transversus abdominis plane block (Group OSTAP). After surgery, EOIB or OSTAP block was administered with 20 mL of .25% bupivacaine then routine analgesia protocol was applied with iv paracetamol, and tramadol. Visual analog scale (VAS) scores and patient-controlled analgesia (PCA) consumption were monitored 24 hours after the operation. It was administered 25 mg pethidine as a rescue analgesic to patients with VAS ≥4.
RESULTS: Thirty six patients for Group EOIB and thirty four patients for Group OSTAP were included in the study. Lower VAS scores were observed in all groups. When PCA consumption, side effects, rescue analgesia consumption, and patient satisfaction were evaluated, there was no statistically significant difference between the groups (P > .05).
CONCLUSIONS: It was observed that EOIB showed similar analgesic activity to the OSTAP block. EOIB may also be a part of postoperative multimodal analgesia by reducing postoperative opioid consumption in LC.