超声引导下竖脊肌平面阻滞对腰椎融合内固定手术镇痛及术后恢复的影响

Effect of erector spinal plane block on analgesia and postoperative recovery of lumbar spine decompression and fusion internal fixation operation

目的探讨超声引导下竖脊肌平面阻滞(ESPB)在腰椎减压融合内固定术中的应用效果。方法选取2022年1月~4月我院行腰椎减压融合内固定术的病人60例,按随机数字表法分为两组,每组各30例。研究组实施ESPB联合气管插管全身麻醉,对照组实施气管插管全身麻醉,记录术中生命体征、麻醉药物使用总量、手术时间,术后不同时段手术切口静息疼痛视觉模拟评分(VAS)、48小时内补救镇痛药物使用比例及镇痛药物相关不良反应。结果两组病人术中生命体征、术中情况、术后36、48小时切口静息VAS评分、术后48小时不良反应发生率比较,差异无统计学意义(P>0.05)。与对照组比较,研究组术中瑞芬太尼用量明显减少,术后2、6、12、24小时切口静息VAS评分降低,术后48小时内补救镇痛药物使用降低,差异有统计学意义(P<0.05)。结论超声引导下ESPB可有效提高腰椎减压融合内固定术病人术后镇痛的效果,有利于术后早期恢复。

Objective To explore the application effect of ultrasound-guided erector spinal muscle plane block(ESPB)in lumbar decompression and fusion internal fixation.Methods Sixty patients with lumbar decompression and fusion internal fixation in this hospital from January to April 2022 were selected and divided into two groups according to the random number table method,thirty cases in each group.The study group implemented the general anesthesia intubation under the ESPB intervention and the control group conducted the general anesthesia intubation.The intraoperative vital signs,total amount of anesthetic drugs use and operation time were recorded.The resting Visual analogue scale(VAS)scores of the incision at different postoperative time periods,and the proportion of remedial analgesic medication use within postoperative 48 h and adverse reactions were recorded.Results There was no statistical difference in the vital signs,intraoperative situation,resting VAS scores of the incision at postoperative 36,48 h and occurrence rate of adverse reactions at postoperative 48 h between the two groups(P>0.05).Compared with the control group,the use amounts of intraoperative remifentanil in the study group were significant decreased(P<0.05).The resting VAS scores of the incision at postoperative 2,6,12,24 h were reduced(P<0.05);the proportion of remedial analgesic drugs use at postoperative 48 h were reduced(P<0.05).Conclusion Ultrasound-guided ESPB can effectively improve the analgesia efficacy for the patients with lumbar decompression fusion and internal fixation,which is conducive to postoperative earlier recovery.