超声引导下连续竖脊肌平面阻滞用于胸腹腔镜联合食管癌根治术患者术后镇痛效果研究

The analgesic efficacy of ultrasound-guided continuous erector spinae block for postoperative analgesia in patients undergoing esophageal cancer with thoracic laparoscopic surgery

目的观察超声引导下连续竖脊肌平面阻滞(ESPB)对胸腹腔镜联合食管癌根治术患者的术后镇痛效果。方法选择行胸腹腔镜联合食管癌根治术患者50例,其中男32例,女18例;ASAⅠ~Ⅱ级,年龄20~64岁,BMI 20~28kg/m^2。随机分为ESPB组(E组)和PCIA(P组),E组于术毕后行超声引导下连续ESPB,P组于术毕后行PCIA(静脉自控镇痛)。记录患者术后1h,6h,12h,24h,48h的静息和动态VAS评分,镇痛泵按压次数,镇痛效果满意度,术后补救镇痛次数和不良反应发生率。结果E组与P组相比,术后48h内静息和动态VAS评分低,镇痛泵按压次数少,镇痛效果满意度高,术后补救镇痛率低(P<0.05)。P组恶心呕吐发生率高于E组(P<0.05)。结论超声引导下连续竖脊肌平面阻滞用于胸腹腔镜食管癌根治术患者术后镇痛效果优于PCIA,且术后不良反应少。

Objective To evaluate the postoperative analgesic effect of ultrasound-guided continuous erector spinae plane block(ESPB) in patients undergoing thoracoscopic and laparoscopic radical esophageal cancer.Methods Fifty patients(32 males and 18 females,aged 20 to 64 years old,BMI 20~28 kg/m^2,ASA physical status I or II),undergoing video-assisted thoracoscopic and laparoscopic radical esophageal cancer,were randomly divided into ESPB group(group E) and PCIA(P group).Patients in group E received ultrasound-guided continuous ESPB block after operation.Patients in group P received PCIA(patient controlled intravenous analgesia).The resting and dynamic VAS scores are recorded 1 h,6 h,12 h,24 h,48 h after the operation respectively,the number of analgesic pump were pressed,the satisfaction of analgesic effect,the number of postoperative remedial analgesia and the incidence of adverse reactions were also recorded.Results Compared with group P,group E had lower resting and dynamic VAS scores within 48 hours after operation,less analgesia pump presses,higher satisfaction with analgesic effect,and lower postoperative remedy analgesia rate(P<0.05).The incidence of nausea and vomiting in group P was higher than that in group E(P<0.05).Conclusion Compared with PCIA,ultrasound-guided continuous erector spinae block in patients undergoing thoracoscopic and laparoscopic radical esophageal cancer has better postoperative analgesia and less adverse reactions.