超声引导下双侧竖脊肌平面阻滞用于腰椎后入路手术的效果

Effect of Ultrasound-guided Bilateral Erector Spinal Plane Block on Lumbar Posterior Operations

目的观察超声引导下双侧竖脊肌平面阻滞用于腰椎后入路手术的效果。方法选择2019年10月-2020年10月安徽医科大学附属巢湖医院行择期腰椎后入路手术患者60例,随机分为观察组(S组)和对照组(P组),每组30例。P组采用单纯全身麻醉方法,S组采用超声引导下双侧ESP联合全身麻醉方法。比较两组患者术中顺阿曲库胺、舒芬太尼、瑞芬太尼、丙泊酚的用量,术后4、8、12、24 h视觉模拟评分(VAS)和PCIA按压次数,以及相关不良反应发生情况。结果S组术中舒芬太尼、瑞芬太尼以及丙泊酚的用量均少于P组(P<0.05);两组顺阿曲库胺用量比较,差异无统计学意义(P>0.05);S组术后不同时间点VAS评分及PCIA按压次数均少于P组,不良反应发生率低于P组(P<0.05)。结论超声引导下双侧ESP能减少腰椎后入路手术患者麻醉药的用量,并能有效的减轻患者术后疼痛,且不良反应少。

Objective To observe the effect of ultrasound-guided bilateral erector spinal block on lumbar posterior operations.Methods Sixty patients who underwent elective lumbar internal fixation surgery in Chaohu Hospital of Anhui Medical University from October 2019 to October 2020 were selected as the research objects,and they were randomly divided into an observation group(group S)and a control group(group P),with 30 cases in each group.The group P was treated with general anesthesia,and the group S was treated with ultrasound-guided bilateral spinal plane block combined with general anesthesia.The intraoperative dosages of cisatracurium besilate,sufentanil,remifentanil and propofol,Visual Analog Scale(VAS)at 4,8,12 h and 24 h after surgery and PCIA pressing times,and occurrence of adverse reactions were compared between the two groups.Results The intraoperative dosage of sufentanil,remifentanil and propofol of group S was less than that those of group P(P<0.05);there was no difference in the dosage of cisatracurium besilate between the two groups(P>0.05).VAS score and PCIA pressing times of group S were lower than those of group P at different postoperative time points,and the incidence of adverse reactions in the group S was lower than in the group P(P<0.05).Conclusion Ultrasound-guided bilateral ESP can reduce the dosage of anesthetics in patients undergoing lumbar posterior approach surgery,and can effectively reduce postoperative pain,with less adverse reactions.